Variation of Perioperative Blood cTnT Levels in Patients Undergoing Cardiopulmonary Bypass and Its Clinical Implication

The clinical value of cardiac Troponin T (cTnT) as a marker in assessing myocardial cell damage in the patients undergoing open heart surgery was studied. Serum cTnT and CK MB levels were measured in serial blood samples from 20 patients undergoing open heart surgery before operation, at aorta clamping, aorta opening, the end of CPB and the operation, and subsequently one h, one day, 3 days and one week after operation respectively. Ten patients receiving thoracic surgery were also subjected to the measurement of cTnT and CK MB before and 24 h after operation. The results showed that peak concentrations were reached earlier in cTnT than in CK MB, and the circulation cTnT remained high when CK MB had already decreased to normal. In 10 patients receiving thoracic surgery, cTnT level was normal and CK MB was increased in 4 patients after surgery. It was concluded that the sensitivity and specificity of cTnT was more than those of CK MB and cTnT could be used as a routine indicator for myocardiac protection.

Myocardial protection of immature rabbits with an ATP-sensitive K^+ channel opener pinacidil

Objective To investigate the effectiveness of pinacidil,an opener of ATP-sensitive K+ channels,in protecting the myocardium of immature rabbit hearts from ischemic reperfusion injury.Methods Rabbit hearts underwent 30 min of global normothermic ischemia followed by 30 min of reperfusion on the modified Langendorff apparatus.Fifty-two isolated hearts of 3 - 4 week-old immature rabbits were divided into 4 groups randomly.During ischemia,3 different cardioplegic solutions were administered intermittently by infusion every 15 min(20-25 mi each time in all groups).Group 1:control group(n = 13);group 2:Krebs-Henseleit(K-H)solution with potassium(16 mmol/L)(n = 1:3);group 3:K-H solution with potassium(16 mmol/L)and pinacidil(50 μmol/L)(n = 13);group 4:K-H solution with potassium(16 mmol/L),pinacidil(50 μmol/L)and glibenclamide(10 μmol/L)(n = 13).The pre-ischemic and post-ischemic myocardial functions were assessed by the percentage recovery of the left ventricular developed pressure(LVDP);the left ventricular end-diastolic pressure(LVEDP);both the Positive peak and negative peaks of the first derivative of the left ventricular pressures(± dp/dtmax);coronary flow;the level of creatine kinase(CK),lactic dehydrogenase(LDH)and aspartate transcarbamoylase(AST)in coronary sinus venous effluent;and by myocardial ultrastructural changes.Results Before myocardial ischemia,there were no significant differences among the four groups in any of the parameters mentioned above.Post-ischemic recovery of LVDP,LVEDP,± dp/dtmax,coronary flow,the level of CK,LDH and AST,and myocardial ultrastructural changes were better in group 3 than those in the three other groups.Conclusions As a new and effective composition,pinacidil can significantly improve myocardial protection from cardioplegia for immature rabbit hearts.

Two new phenolic amides from Allium chinense

Objective: To isolate the phenolic amides from the dried bulbs of Allium chinense and investigate their myocardium protective activities.Methods: The chemical constituents were isolated and purified by combining with silica gel column,Sephadex LH-20 column, HPLC and other chromatography techniques. Their structures were elucidated by NMR techniques and mass spectrometry. The isolated compounds were evaluated to determine their protective effect for myocardium cells in vitro.Results: Two new phenolic amides, namely, alichinemide Ⅰ(1) and alichinemide Ⅱ(2), and six konwn amides were isolated from the dried bulbs of A. chinense. The structures of compounds 3–8 were identified as 3-indolcarbaldehyde(3), 1-(2-aminophenyl)urea(4), 2,3,4,9-tetrahydro-1H-pyrido[3,4-b]indole-3-carboxylic acid(5), N-trans-feruloyltyramine(6), N-trans-p-coumaroyltyramine(7), and N-(3,4-dimethoxyphenethyl) acetamide(8). Compound 3(50 μmol/L) showed significant inhibitory effect on the damage of H9c2 myocardial cells induced by H2O2in vitro.Conclusion: Compounds 1 and 2 were new phenolic amides. Compound 3 could be one of the potential myocardium protective constituents of A. chinense.