Leukocyte-depleted terminal blood cardioplegia provides superior myocardial protective effects in association with myocardium-derived nitric oxide and.

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Presentation transcript:

Leukocyte-depleted terminal blood cardioplegia provides superior myocardial protective effects in association with myocardium-derived nitric oxide and peroxynitrite production for patients undergoing prolonged aortic crossclamping for more than 120 minutes Yoshitaka Hayashi, MD, PhD, Yoshiki Sawa, MD, PhD, Naoto Fukuyama, MD, PhD, Yuji Miyamoto, MD, PhD, Toshiki Takahashi, MD, PhD, Hiroe Nakazawa, MD, PhD, Hikaru Matsuda, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 126, Issue 6, Pages 1813-1821 (December 2003) DOI: 10.1016/S0022-5223(03)01282-0

Figure 1 a, Relation between the aortic crossclamping time (AXC time) and plasma level of polymorphonuclear-elastase in the arterial blood (PMNE in Ao) (PMNE in Ao = 156.189 + 4.189 × AXC time; R2 = .834). b, Comparisons of PMNE in Ao among the 4 groups. Data are expressed as mean ± SD. *P < .0001 vs CONT-S or LDTC-S. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 1813-1821DOI: (10.1016/S0022-5223(03)01282-0)

Figure 2 Changes in the plasma levels nitrate + nitrite (NOx) in the blood obtained from aortic root and coronary sinus, before cardiopulmonary bypass and 5 minutes after aortic unclamping. Data are expressed as mean ± SD. *P < .0001 vs Ao before ischemia or CS before ischemia. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 1813-1821DOI: (10.1016/S0022-5223(03)01282-0)

Figure 3 a, Changes in the percentage ratio of plasma nitrotyrosine to tyrosine (%NO2-Tyr) in the blood obtained from aortic root (Ao) and coronary sinus (CS), before cardiopulmonary bypass and 5 minutes after aortic unclamping. Data are expressed as mean ± SD. *P < .0001; Ao vs CS after reperfusion. b, Comparisons of the difference in %NO2-Tyr between coronary sinus effluent and arterial blood (CS-Ao in %NO2-Tyr) 5 minutes after aortic unclamping. Data are expressed as mean ± SD. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 1813-1821DOI: (10.1016/S0022-5223(03)01282-0)

Figure 4 Relations between (a) the aortic crossclamping time (AXC time) and the difference in the percentage ratio of plasma nitrotyrosine to tyrosine between coronary sinus effluent and arterial blood (CS-Ao in %NO2-Tyr) 5 minutes after aortic unclamping. Group LDTC: CS-Ao in %NO2-Tyr = −0.351 + 0.021 × AXC time (R2 = .809); group CONT (LDTC (−)): CS-Ao in %NO2-Tyr = 1.834 + 0.039 × AXC time (R2 = .871). Relations between (b) CS-Ao in %NO2-Tyr and the difference in the plasma levels of polymorphonuclear-elastase (CS-Ao difference in PMNE) 5 minutes after aortic unclamping. Group LDTC: CS-Ao difference in %NO2-Tyr = 0.441 + 0.029 × CS-Ao difference in PMNE (R2 = .798); group CONT (LDTC (−)): CS-Ao difference in %NO2-Tyr = 0.116 + 0.023 × [CS-Ao difference in PMNE (R2 = .672)]. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 1813-1821DOI: (10.1016/S0022-5223(03)01282-0)

Figure 5 Comparisons of (a) the difference in plasma polymorphonuclear-elastase between coronary sinus effluent and arterial blood 5 minutes after aortic unclamping (CS-Ao difference in PMNE); (b) the difference in plasma malondialdehyde between coronary sinus effluent and arterial blood 5 minutes after aortic unclamping (CS-Ao difference in MDA); (c) plasma human-heart fatty acid–binding protein in the arterial blood 45 minutes after aortic unclamping (HH-FABP); and (d) peak plasma creatine kinase–muscle and brain during the first 24 postoperative hours (peak CK-MB). Data are expressed as mean ± SD. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 1813-1821DOI: (10.1016/S0022-5223(03)01282-0)