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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2002 June;43(3):319-26
Ischemic preconditioning protects right ventricular function in coronary artery bypass grafting patients experiencing angina within 48-72 hours
Wu Z. K., Pehkonen E., Laurikka J., Kaukinen L. *, Honfonen E. L. *, Kaukinen S. *, Tarkka M. R.
From the Division of Cardiac Surgery
*Department of Anesthesiology and Intensive Care Tampere University Hospital Tampere, Finland
Background. To test whether ischemic preconditioning (IP) is able to protect the myocardium in recently unstable CABG patients.
Methods. Experimental design: prospective, randomised, controlled clinical study. Setting: University Hospital. Patients: Forty CABG patients with recent unstable angina were randomised into an IP group (n=20) and a control group (n=20). Subgroup was devided based on the time of the most recent ischemia onset before the operation. Intervention: The IP group was preconditioned with 2 cycles of 2-min ischemia followed by 3-min reperfusion before cross clamping. Measures: Hemodynamic data were monitored till the 1st POD. Biochemical markers were measured till the 2nd POD.
Results. There were no differences in cardiac index (Cl) and right ventricular ejection fraction (RVEF) in patients experiencing angina within 48 hours prior to operation. The percentage changes in CI and RVEF at 1 hour after declamping were significantly better in the IP group in patients experienced angina within 48-72 hours (106% vs 88% of baseline, p=0.027 and 103% vs 81% of baseline, p=0.023). No difference in postoperative cardiac troponin I (CTnI) and CK-MB was found between the IP and controls in either subgroup.
Conclusions. IP has a beneficial effect on global and right ventricular hemodynamic functional recovery in unstable CABG patients experiencing angina within 48-72 hours prior to the operation. However, IP has no additional protective effects in unstable CABG patients who experience angina within 48 hours.