Abstract:
BACKGROUND:Ischemic preconditioning is a method that prepares and protects cells to tolerate a long period of ischemia with the least possible injury. OBJECTIVES:Evaluate the influence of ischemic preconditioning over left ventricular function during off-pump myocardial revascularization. METHOD:Forty patients with clinical indication for off-pump myocardial revascularization were randomized in two groups, with or without ischemic preconditioning. Ischemic preconditioning was carried out by performing coronary occlusion for two minutes and releasing blood flow for one minute; two cycles were performed. Left ventricular contractility was evaluated through transesophageal Doppler by measuring blood flow acceleration in the descending aorta - Hemosonic 100. The acceleration measurements were performed at the start of the surgery, after heart positioning and five and ten minutes after coronary occlusion. RESULTS:There was no significant difference in left ventricular contractility between the two groups. At the beginning of the procedure flow acceleration was 9.37 +/- 2.9m/s(2) in the preconditioning group and 12.5 +/- 3.1 m/s(2) in no-preconditioning group (p = 0.23); after positioning of heart, it was 8.47 +/- 3.3 and 8.31 +/- 3.6 m/s(2) (p = 0.96); after five minutes - 8.7 +/- 4.1 and 7.94 +/- 2.9 m/s(2) (p = 0.80); and after ten minutes - 9.2 +/- 4.5 and 7.98 +/- 3.4 m/s(2) (p = 0.71). However, contractility evolution was different throughout time in each group. The preconditioning group maintained left ventricular contractility during the entire procedure, since the beginning (0.52), while the group without ischemic preconditioning presented reduction in left ventricular contractility (p = 0.0034). CONCLUSION:Ischemic preconditioning prevented the decrease in left ventricular contractility during off-pump myocardial revascularization surgery.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Succi JE,Gerola LR,Succi GM,Almeida RA,Novais LS,Rocha Bdoi
10.1590/s0066-782x2010000300010subject
Has Abstractpub_date
2010-03-01 00:00:00pages
319-24, 339-44issue
3eissn
0066-782Xissn
1678-4170pii
S0066-782X2010000300010journal_volume
94pub_type
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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