Optimal dose and mode of delivery of Na+/H+ exchange-1 inhibitor are critical for reducing postsurgical ischemia-reperfusion injury Joel S Corvera, MD,

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Presentation transcript:

Optimal dose and mode of delivery of Na+/H+ exchange-1 inhibitor are critical for reducing postsurgical ischemia-reperfusion injury Joel S Corvera, MD, Zhi-Qing Zhao, MD, PhD, L.Susan Schmarkey, BS, Sara L Katzmark, BS, Jason M Budde, MD, Cullen D Morris, MD, Thomas Ehring, PhD, Robert A Guyton, MD, Jakob Vinten-Johansen, PhD The Annals of Thoracic Surgery Volume 76, Issue 5, Pages 1614-1622 (November 2003) DOI: 10.1016/S0003-4975(03)00958-5

Fig 1 Determination of area at risk. The left anterior descending coronary artery (LAD) was ligated at the point of reversible occlusion. Unisperse blue dye was injected directly into right main coronary artery, LAD, and left circumflex coronary artery by way of the coronary ostia to outline area at risk (regions that are not blue). The Annals of Thoracic Surgery 2003 76, 1614-1622DOI: (10.1016/S0003-4975(03)00958-5)

Fig 2 Infarct size. Area at risk (AAR) is expressed as percentage of left ventricular mass (LV). Infarct size as area of necrosis (NEC) is expressed as percentage of AAR. * = p = 0.003 versus control and p = 0.056 versus EMD-10. (Control = blood cardioplegia without supplementation; EMD-10 = blood cardioplegia supplemented with 10 μmol/L EMD 87580; EMD-20 = blood cardioplegia supplemented with 20 μmol/L EMD 87580; EMD-20R = blood cardioplegia supplemented with 20 μmol/L EMD 87580 plus infusion of 5 mg/kg of EMD 87580 5 minutes before terminal “hot-shot” cardioplegia.) The Annals of Thoracic Surgery 2003 76, 1614-1622DOI: (10.1016/S0003-4975(03)00958-5)

Fig 3 Plasma creatine kinase (CK) activity. (Control = blood cardioplegia without supplementation; EMD-10 = blood cardioplegia supplemented with 10 μmol/L EMD 87580; EMD-20 = blood cardioplegia supplemented with 20 μmol/L EMD 87580; EMD-20R = blood cardioplegia supplemented with 20 μmol/L EMD 87580 plus infusion of 5 mg/kg of EMD 87580 5 minutes before terminal “hot-shot” cardioplegia; R1 = reperfusion 1 minute after aortic cross-clamp removal; R30 = reperfusion for 30 minutes with heart beating during cardiopulmonary bypass; R60, R90, R120 = minutes of reperfusion.) The Annals of Thoracic Surgery 2003 76, 1614-1622DOI: (10.1016/S0003-4975(03)00958-5)

Fig 4 Myocardial tissue water content in nonischemic myocardium, ischemic-reperfused area at risk in subepicardium (AAR Epi), and ischemic-reperfused area at risk in subendocardium (AAR Endo). * = p < 0.05 versus control. (Control = blood cardioplegia without supplementation; EMD-10 = blood cardioplegia supplemented with 10 μmol/L EMD 87580; EMD-20 = blood cardioplegia supplemented with 20 μmol/L EMD 87580; EMD-20R = blood cardioplegia supplemented with 20 μmol/L EMD 87580 plus infusion of 5 mg/kg of EMD 87580 5 minutes before terminal “hot-shot” cardioplegia.) The Annals of Thoracic Surgery 2003 76, 1614-1622DOI: (10.1016/S0003-4975(03)00958-5)