Application of myocardial protection fluid in infant open heart operation

doi:10.3969/j.issn.2095-4344.2013.31.013

Abstract

Abstract:

BACKGROUND: The research at home and abroad for appropriate immature myocardial cardioplegia has no breakthrough, and it may be a better mean to improve the protection effect of existing cardioplegia on immature myocardial by adding ingredients. Adenosine can reduce ischemia and neutrophil-mediated reperfusion injury, and salvia miltiorrhiza can reduce the content of ischemic myocardial lipid peroxide and increase the scavenging of myocardial cells to oxygen radical.
OBJECTIVE: To investigate the protection effect of improved myocardial protection fluid containing adenosine and salvia miltiorrhiza on the heart, liver and kidney.
METHODS: Sixty cases of infant open heart operation of the first time were randomly divided into three groups, 20 cases in each group. The adenosine group received the improved myocardial protection fluid added with adenosine, the combination group received the improved myocardial protection fluid added with adenosine and miltiorrhiza salvia, and the control group received the improved myocardial protection fluid in the same volume. The blood samples were taken at the time before anesthesia induction, 30 minutes after cardio pulmonary bypass beginning, 1 hour after cardio pulmonary bypass end and 24 hours after cardio pulmonary bypass end. The serum levels of the creatine kinase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, tumor necrosis factor-α, interleukin-6, interleukin-8 and interleukin 10 were detected.
RESULTS AND CONCLUSION: The serum levels of the alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and creatine kinase in three groups were increased, but the control group was increased significantly (P < 0.01), and there were significant differences between adenosine group and combination group (P < 0.05); the levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 were significantly increased after operation (P < 0.05). The levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 in the control group were significantly higher than those in the adenosine group and combination group before induction and at the same time point (P < 0.01); at 3 minutes and 24 hours after cardio pulmonary bypass, the level of interleukin-10 was increased in three groups, but the level of interleukin-10 in the adenosine group was significantly higher than that in the control group (P < 0.01). The results indicate that improved myocardial protection fluid has great protection effect on immature myocardial, and can significantly reduce the serum levels of tumor necrosis factor-α, interleukin-6 and interleukin-8, promote the secretion of interleukin-10 that can inhibit inflammatory cytokine and can significantly reduce the inflammatory response caused by cardiopulmonary bypass. So the improved myocardial protection fluid has protection effect on important organs, such as heart, lung, liver and kidney.

Key words: organ transplantation, basic experiments of organ transplantation, cardiopulmonary bypass, myocardial protection fluid, adenosine injection, salvia miltiorrhiza injection, inflammatory factor, lung protection, cardiac surgical procedures, provincial grants-supported paper

CLC Number:

R318

Cheng Guang-cun, Cheng Ming-guang, Tang Dan-dan, Dong Gui-fu, Cai Yan, Jiang Bo, Yan Zhong-ya. Application of myocardial protection fluid in infant open heart operation[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.31.013.

Figures/Tables 2

References

[1] Zhang YW, Ma XY, Ding SD, et al.[Effects of compound salvia miltiorrhiza injection on aquaporin 3 expression in human amniotic epithelial cells].Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013;33(1):51-55.

[2] Zhang L, Dai SZ, Nie XD, et al.Effect of Salvia miltiorrhiza on retinopathy.Asian Pac J Trop Med. 2013;6(2): 145-149.

[3] Zeng X, Zhang L, Sun L, et al. Recovery from rat sciatic nerve injury in vivo through the use of differentiated MDSCs in vitro. Exp Ther Med. 2013;5(1):193-196.

[4] Gao Y, Wang N, Zhang Y, et al. Mechanism of protective effects of Danshen against iron overload-induced injury in mice.J Ethnopharmacol. 2013;145(1):254-260.

[5] Miao B, Wang J, Zhu Y, et al. Experimental study on effect of Salvia miltiorrhiza on alveolar bone metabolism and variation in bone mass in diabetic rats].Zhongguo Zhong Yao Za Zhi. 2012;37(11):1659-1662.

[6] Ding LT, Zhu YG, Gu ZQ, et al. [Effect of salvia miltiorrhiza and Ligustrazine injection on the early myocardial damage of patients with severe burn].Zhonghua Shao Shang Za Zhi. 2012;28(3):170-172.

[7] Yu J, Fei J, Azad J, et al. Myocardial protection by Salvia miltiorrhiza Injection in streptozotocin-induced diabetic rats through attenuation of expression of thrombospondin-1 and transforming growth factor-β1.J Int Med Res. 2012;40(3): 1016-1024.

[8] Zhao LJ, Men XL, Kong XY, et al. Preventive effects of Salvia miltiorrhiza on multiple organ edema in the rats of limb ischemia/reperfusion].Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2012;28(3):281-283.

[9] Wang AM, Tang H, Bao DY, et al. Effects of salvia miltiorrhiza injection on gentamicin-induced expression of nitric oxide synthase isoforms in guinea pig cochlea].Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2011;27(2):246-249.

[10] Liu J, Zhang D, Li J, et al. Effects of Salvia miltiorrhiza and Carthamus tinctorius aqueous extracts and compatibility on rat myocardial ischemic reperfusion injury. Zhongguo Zhong Yao Za Zhi. 2011;36(2):189-194.

[11] Zhang ZY, Chen XP, Lu QP.Effect of Salvia miltiorrhiza pretreatment on the CCK and VIP expression in hepatic ischemia-reperfusion-induced digestive tract congestion.Front Med China. 2010;4(3):317-322.

[12] Wang X, Yeung JH.Effects of the aqueous extract from Salvia miltiorrhiza Bunge on caffeine pharmacokinetics and liver microsomal CYP1A2 activity in humans and rats.J Pharm Pharmacol. 2010;62(8):1077-1083.

[13] Palfreeman AC, McNamee KE, McCann FE.New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast.Drug Des Devel Ther. 2013; 7:201-210.

[14] Soleimani M, Katebi M, Alizadeh A, et al. The Role of The A2A Receptor in Cell Apoptosis Caused by MDMA.Cell J. 2012; 14(3):231-236.

[15] Wang CR, Qiao WT, Zhang YN, et al. Effects of adenosine extract from Pholiota adiposa (Fr.) quel on mRNA expressions of superoxide dismutase and immunomodulatory cytokines. Molecules. 2013;18(2):1775-1782.

[16] Lu WH, Wang CY, Chen PS, et al. Valproic acid attenuates microgliosis in injured spinal cord and purinergic P2X4 receptor expression in activated microglia.J Neurosci Res. 2013;91(5):694-705.

[17] Teragawa H, Mitsuba N, Ishibashi K, et al. Evaluation of coronary microvascular function in patients with vasospastic angina.World J Cardiol. 2013;5(1):1-7.

[18] Tavares AA, Batis J, Barret O, et al. In vivo evaluation of [(123)I]MNI-420: a novel single photon emission computed tomography radiotracer for imaging of adenosine 2A receptors in brain.Nucl Med Biol. 2013;40(3):403-409.

[19] Nakamura T, Hachiya H, Tanaka Y, et al. Distribution of the origin of adenosine triphosphatesensitive atrial tachycardias with the earliest activation recorded in the his bundle catheter- are they limited to the immediate vicinity of the His bundle? Circ J. 2013;77(3):626-631.

[20] Kermanian F, Soleimani M, Ebrahimzadeh A, et al. Effects of adenosine A2a receptor agonist and antagonist on hippocampal nuclear factor-kB expression preceded by MDMA toxicity.Metab Brain Dis. 2013;28(1):45-52.

[21] Arumugham P, Figueredo VM, Patel PB, et al. Comparison of intravenous adenosine and intravenous regadenoson for the measurement of pressure-derived coronary fractional flow reserve.EuroIntervention. 2013;8(10):1166-1171.

[22] Jiao YY, Wang XQ, Lu WL, et al. A novel approach to improve the pharmacokinetic properties of 8-chloro-adenosine by the dual combination of lipophilic derivatisation and liposome formulation.Eur J Pharm Sci. 2013;48(1-2):249-258.

[23] Huynh TP, Pietrzyk-Le A, Bikram KCC, et al. Electrochemically synthesized molecularly imprinted polymer of thiophene derivatives for flow-injection analysis determination of adenosine-5'-triphosphate (ATP).Biosens Bioelectron. 2013;41:634-641.

[24] Ji F, Wang Z, Ma N, et al. Herkinorin dilates cerebral vessels via kappa opioid receptor and cyclic adenosine monophosphate (cAMP) in a piglet model.Brain Res. 2013; 1490:95-100

[25] Yamaoka G, Horiuchi H, Morino T, et al. Different analgesic effects of adenosine between postoperative and neuropathic pain.J Orthop Sci. 2013;18(1):130-136.

[26] Boison D, Chen JF, Fredholm BB.Adenosine signaling and function in glial cells.Cell Death Differ. 2010;17(7):1071-1082.

[27] Yu FX, Ke JJ, Fu Y, et al. Protective effects of adenosine in rabbit sinoatrial node ischemia-reperfusion model in vivo: control of arrhythmia by hyperpolarization-activated cyclic nucleotide-gated (HCN)4 channels.Mol Biol Rep. 2011;38(3): 1723-1731.

[28] Vasudevan K, Sztein JM.Treatment of sperm with extracellular adenosine 5'-triphosphate improves the in vitro fertility rate of inbred and genetically modified mice with low fertility.Theriogenology. 2011;76(4):729-736.

[29] Wang Q, Gai LY, Chen YD, et al. [Value of combined CT coronary angiography and adenosine stress myocardial perfusion scintigraphy for diagnosis of coronary artery disease].Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39(3):233-237.

[30] Ramlackhansingh AF, Bose SK, Ahmed I, et al. Adenosine 2A receptor availability in dyskinetic and nondyskinetic patients with Parkinson disease. Neurology. 2011;76(21):1811-1816.

[31] Ding LT, Zhu YG, Gu ZQ, et al. Effect of salvia miltiorrhiza and Ligustrazine injection on the early myocardial damage of patients with severe burn.Zhonghua Shao Shang Za Zhi. 2012; 28(3):170-172.

[32] Pagel PS, Gandhi SD, Iqbal Z, et al. Cardiopulmonary bypass transiently inhibits intraventricular vortex ring formation in patients undergoing coronary artery bypass graft surgery.J Cardiothorac Vasc Anesth. 2012;26(3):376-380.

[33] Wu D, Qi J.Mechanisms of the beneficial effect of NHE1 inhibitor in traumatic hemorrhage: inhibition of inflammatory pathways.Resuscitation. 2012;83(6):774-781.

[34] Tempe DK, Dutta D, Garg M, et al. Myocardial protection with isoflurane during off-pump coronary artery bypass grafting: a randomized trial. J Cardiothorac Vasc Anesth. 2011;25(1): 59-65.

[35] Arata K, Iguro Y, Yotsumoto G, et al. Use of continuous retrograde gaseous oxygen persufflation for myocardial protection during open heart surgery.Surg Today. 2010;40(6): 549-554.

[36] Lindquist BE, Shuttleworth CW.Adenosine receptor activation is responsible for prolonged depression of synaptic transmission after spreading depolarization in brain slices. Neuroscience. 2012;223:365-376.

[37] Ichinose TK, Minic Z, Li C, et al. Activation of NTS A1 adenosine receptors inhibits regional sympathetic responses evoked by activation of cardiopulmonary chemoreflex.Am J Physiol Regul Integr Comp Physiol. 2012;303(5):R539-550.

[38] Zhang H, Tian NL, Hu ZY, et al. Three hours continuous injection of adenosine improved left ventricular function and infarct size in patients with ST-segment elevation myocardial infarction.Chin Med J (Engl). 2012;125(10):1713-1719.

[39] Seo MK, Koo BK, Kim JH, et al. Comparison of hyperemic efficacy between central and peripheral venous adenosine infusion for fractional flow reserve measurement.Circ Cardiovasc Interv. 2012;5(3):401-405.

[40] Andersson O, Adams BA, Yoo D, et al. Adenosine signaling promotes regeneration of pancreatic β cells in vivo.Cell Metab. 2012;15(6):885-894.

[41] Wang J, Ma Z, Hong Z, et al. Tissue distribution in mice of danshensu from sodium danshensu and Salvia miltiorrhiza injection.Zhongguo Zhong Yao Za Zhi. 2011;36(11): 1516- 1518.

[42] Li Y, Shen L, Chen R, et al. Effects of Salivae Miltiorrhizae Liguspyragine hydrochloride and glucose injection on the levels of main platelet thrombin receptors in chronic haemodialysis patients. Chin J Integr Med. 2011;17(8): 625-630.