Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (44): 8289-8292.doi: 10.3969/j.issn.1673-8225.2011.44.030

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Relationship between myocardial inflammatory response and the myocardial protective effect of on-pump beating-heart technique with mild hypothermia

Zhou Tao, He Wei, Zheng Bao-shi, Feng Xu, Xie Xiao-yong   

  1. Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021,Guangxi Zhuang Autonomous Region, China
  • Received:2011-05-26 Revised:2011-06-27 Online:2011-10-29 Published:2011-10-29
  • Contact: He Wei, Professor, Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021,Guangxi Zhuang Autonomous Region, China
  • About author:Zhou Tao☆, Studying for doctorate, Associate chief physician, Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China

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Abstract:

BACKGROUND: On-pump beating-heart technique has been promoted as better systemic protection compared with the technique of cardioplegic arrest, and the attenuated inflammatory response may play an important role in the protective effect of the on-pump beating-heart technique.
OBJECTIVE: To investigate the relationship between local inflammatory response and the myocardial protective effect of on-pump beating-heart technique with mild hypothermia in patients with artificial mechanical heart valve replacements.
METHODS: Forty patients undergoing elective mechanical mitral valve replacements with cardiopulmonary bypass (CPB) were eligible for inclusion in the study. The patients were randomly divided into control group and beating group with 20 patients in each group. The conventional approach was used in control group, while the heart was kept empty and beating throughout the operation in beating group. In all patients, blood samples withdrawn from the right atrium or the coronary sinus before the CPB, 30 minutes after the start of CPB, or before the right atrium was closed, were assayed for plasma levels of interleukin (IL)-6, IL-8, tumor necrosis factor-alpha (TNF-α), and cardiac troponin I(cTnI) levels. Meanwhile, the right atrial myocardial tissue samples were taken to detect myocardial cell nuclear transcription factor kappa B (NF-κB) expression when the right atrium was opened and closed.
RESULTS AND CONCLUSION: There were no significant differences between control and beating groups in terms of demographic, pre-operative or operative parameters. In both groups, compared with the baseline values, plasma levels of IL-6, IL-8, TNF-α and cTnI were gradually increased during CPB. Compared with the control group, the increasing degrees of IL-6, IL-8, TNF-α, and cTnI were significantly lower in the beating group (P < 0.05). The increased expression of NF-κB was lower in beating group than that in control group (P < 0.05). These results suggest that the attenuated myocardial inflammatory response plays an important role in myocardial protection of on-pump beating-heart technique with mild hypothermia.

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