Efeitos das cardioplegias sangüíneas hipotérmica e normotérmica nos substratos intracelulares em pacientes com corações hipertróficos

Gomes, Walter J.; Ascione, Raimondo; Suleiman, M.Saadeh; Bryan, Alan J.; Angelini, Gianni D

doi:10.1590/s0102-76382000000200009

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…This kind of cardioplegia has shown to reduce ischemic and functional damage either reducing the increase of serum troponins [66,67] or as a lower increase of lactate [68] and better functional preservation [69].…”

Section: Blood Cardioplegiamentioning

confidence: 99%

Proteção miocárdica ao coração hipertrofiado: o eterno desafio

Cressoni¹,

Avanci²,

Braile³

et al. 2008

Rev Bras Cir Cardiovasc

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The myocardial protection allowed great advance in cardiac surgery, decreasing the mortality and making more feasible complex surgeries. Latterly the patient population elected for cardiac procedures has been changing towards elderly patients with ventricular function depressed and myocardial hypertrophy. The myocardial hypertrophy condition represents a great challenge since the beginning of the cardiac surgery. Several techniques have been described to protect the myocardial hypertrophy, however with no satisfactory results. In this manuscript we present the state of the art technique of myocardial protection. 98CRESSONI, ES ET AL -Myocardial protection to the hypertrophied heart: the eternal challenge Bras Cir Cardiovasc 2008; 23(1): 97-107 Rev

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Section: Blood Cardioplegiamentioning

confidence: 99%

Proteção miocárdica ao coração hipertrofiado: o eterno desafio

Cressoni¹,

Avanci²,

Braile³

et al. 2008

Rev Bras Cir Cardiovasc

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“…Trabalhos experimentais têm demonstrado que a interrupção ou infusão intermitente de soluções cardioplégicas sangüíneas é prejudicial (55)(56)(57)(58) , embora recentemente, GOMES (58) , avaliando pacientes portadores de estenose aórtica operados sob infusão intermitente de soluções cardioplégicas sangüíneas em normo ou hipotermia, concluiu que ambas as soluções não foram eficientes, do ponto de vista bioquímico, em proteger o miocárdio.…”

Section: Fase IIunclassified

“…Apesar do potencial malefício inerente à infusão de soluções cardioplé gicas sangüíneas normotérmicas (55)(56)(57)(58) ), mesmo por curtos períodos, essa tática ganhou adeptos na prática clínica que relataram resultados iguais ou superiores aos obtidos com soluções hipotérmicas (3, 6, 8-10, 12, 15) .…”

Section: Fase IIunclassified

Cardioplegia sangüínea anterógrada intermitente normotérmica e hipotérmica: estudo comparativo em corações agudamente isquêmicos de coelhos

Rodrigues

Vicente

Carneiro

et al. 2000

Rev Bras Cir Cardiovasc

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“…Cardioplegic strategies to protect the hypertrophic heart during cardiac surgery is, surely, the most controversial subject concerning cardioprotection and an eternal challenge since all tested cardioplegic techniques confer suboptimal myocardial protection. Therefore, we should always have in mind that the state-of-the-art was not achieved yet [26][27][28][29][30]. …”

mentioning

confidence: 99%

Sanguineous normothermic, intermittent cardioplegia, effects on hypertrophic myocardium. Morphometric, metabolic and ultrastructural studies in rabbits hearts

Carbone¹,

Roselino²,

Mello³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Sanguineous normothermic, intermittent cardioplegia, effects on hypertrophic myocardium. Morphometric, metabolic and ultrastructural studies in rabbits hearts Abstract Objectives: The present investigation aimed to study the protective effect of intermittent normothermic cardioplegia in rabbit's hypertrophic hearts.Methods: The parameters chosen were 1) the ratio heart weight / body weight, 2) the myocardial glycogen levels, 3) ultrastructural changes of light and electron microscopy, and 4) mitochondrial respiration.Results: 1) The experimental model, coarctation of the aorta induced left ventricular hypertrophy; 2) the temporal evolution of the glycogen levels in hypertrophic myocardium demonstrates that there is a significant decrease; 3) It was observed a time-dependent trend of higher oxygen consumption values in the hypertrophic group; 4) there was a significant time-dependent decrease in the respiratory coefficient rate in the hypertrophic group; 5) the stoichiometries values of the ADP: O2 revealed the downward trend of the values of the hypertrophic group; 6) It was possible to observe damaged mitochondria from hypertrophic myocardium emphasizing the large heterogeneity of data.Conclusion: The acquisition of biochemical data, especially the increase in speed of glycogen breakdown, when anatomical changes are not detected, represents an important result even when considering all the difficulties inherent in the process of translating experimental results into clinical practice. With regard to the adopted methods, it is clear that morphometric methods are less specific. Otherwise, the biochemical data allow detecting alterations of glycogen concentrations and mitochondria respiration before the morphometric alterations should be detected Descriptors: Heart arrest, induced. Hypertrophy, left ventricular. Cardiovascular surgical procedures. 622Rev Bras Cir Cardiovasc 2012;27(4):621- INTRODUCTIONThe current success of cardiac surgery was provided, among other relevant factors, by better understanding the myocardium protection. The timeline of this understanding includes: 1) systemic hypothermia [1]; 2) intra-operative cardiac arrest induced by potassium citrate [2]; 3) anoxic arrest of the heart [3]; 4) the use of chemicals that could rapidly determine cardiac arrest [4]; 5) Miscellaneous studies relating to the composition, temperature and mode of drug administration named cardioplegic solution [5][6][7], and; 6) normothermic cardioplegia [8,9].In cardiac hypertrophy, whether it is induced in an experimental model or observed clinically, energy metabolism is compromised highlighting that Sink et al.[10] demonstrated that the hypertrophic heart must be stopped immediately emphasizing the need of additives to the cardioplegia solution. It is noteworthy that Cooley et al., in 1972, described the "Stone Heart", i.e., ischemic contracture, more frequent and severe in the hypertrophic heart [11]. This ischemia/reperfusion phenomenon allowed the resumption of the discussion, and final conclusion, about the pivota...

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Efeitos das cardioplegias sangüíneas hipotérmica e normotérmica nos substratos intracelulares em pacientes com corações hipertróficos

Cited by 3 publications

References 32 publications

Proteção miocárdica ao coração hipertrofiado: o eterno desafio

Proteção miocárdica ao coração hipertrofiado: o eterno desafio

Cardioplegia sangüínea anterógrada intermitente normotérmica e hipotérmica: estudo comparativo em corações agudamente isquêmicos de coelhos

Sanguineous normothermic, intermittent cardioplegia, effects on hypertrophic myocardium. Morphometric, metabolic and ultrastructural studies in rabbits hearts

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