The Effects of Intracoronary Administration of Vitamin E on Myocardial Ischemia-Reperfusion Injury During Coronary Artery Surgery

Canbaz, Suat; Durán, Eduardo; Ege, T.; Sunar, Hasan; Çıkırıkçıoğlu, Mustafa; Acipayam, Mehmet

doi:10.1055/s-2003-38983

Cited by 25 publications

(20 citation statements)

References 17 publications

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“…Canbaz et al demonstrated the beneficial effect of intracoronary administration of vitamin E (100 mg) at the end of aortic cross clamping during coronary artery surgery on myocardial cell injury. The endpoint in this study was troponine-I release and lactate production [62]. In contrast, Lassnigg et al [63] demonstrated no effect of intravenously administration of vitamin E (4 times 270 mg, between 12 h before until 2 days after cardiac surgery).…”

Section: Odrf-scavengers/antioxidantiacontrasting

confidence: 58%

Myocardial ischemia/reperfusion-injury, a clinical view on a complex pathophysiological process

Moens

Claeys

Timmermans

et al. 2005

International Journal of Cardiology

381

321

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Section: Odrf-scavengers/antioxidantiacontrasting

confidence: 58%

Myocardial ischemia/reperfusion-injury, a clinical view on a complex pathophysiological process

Moens

Claeys

Timmermans

et al. 2005

International Journal of Cardiology

381

321

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“…However, these protective effects decreased as the time passed. It is not clear wheather this effect might be related to the preoperative dosage given, because there is no report on a standardized scheme of dose for the parenteral use of vitamin E. 21 The TAC levels in the vitamin E group were higher than in the control group in the early phase of the operation, which implied that vitamin E had a major role in the serum TAC level. Although the levels of TAC and MDA were similar at 60 minutes, electron-microscopic examination revealed that there were more patients with grade 2 injury than those with grade 3 injury at 60 minutes in the vitamin E group, whereas in the control group, there were more patients with grade 3 injury.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Vitamin E in the Prevention of Lung Ischemia-Reperfusion Injury After Cardiopulmonary Bypass in Open Heart Surgery

Acipayam¹,

Sunar²,

Canbaz³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The purpose of the study was to investigate the effects of vitamin E in the protection of the lung from potential ischemia-reperfusion injury during elective coronary artery bypass graft surgery. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This controlled randomized single-center study included patients who underwent elective coronary bypass grafting (CABG) operation. Forty-nine patients were randomly divided into 2 groups. Water soluble Vitamin E (100 mg) in tepid saline (n=25) or tepid saline alone (n=24) was administered via the jugular vein before the aortic cross clamping. Serum total antioxidant capacity (TAC) levels and serum malonedialdehyde levels (MDA) were measured. Pulmonary biopsies were obtained before the aortic cross clamping and 60 minutes after removing the cross clamp. Biopsies were examined histopathologically under electron microscopy. R Re es su ul lt ts s: : Serum MDA levels at T1 (15 minutes after removal of the cross clamp) and T2 (30 minutes after removal of the cross clamp) were higher in the control group compared to the Vitamin group. Serum TAC levels at T1, T2 and T3 (60 minutes after removal of the cross clamp) were higher in the Vitamin E group compared to the control group. Histopathologic injury grade was lower in the Vitamin E group than in the control group. C Co on nc cl lu us si io on n: : Vitamin E was found to be protective against reperfusion induced oxidative injury in the early operative period.K Ke ey y W Wo or rd ds s: : Vitamin E; cardiopulmonary bypass; lung injury; reperfusion injury Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, elektif koroner baypas cerrahisi sırasında, akciğerdeki potansiyel iskemi reperfüzyon hasarını önlemede E vitamininin etkinliğini değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu kontrollü, randomize, tek merkezli çalışma, elektif koroner arter baypas greftleme (KABG) operasyonu geçiren hastalarda yapıldı. Çalışmaya toplam 49 hasta alındı ve hastalar rastgele 2 gruba ayrıldı. Yirmi beş olguya aortik kross klemp yerleştirilmeden önce suda eriyen 100 mg E vitamini içeren serum fizyolojik, 24 olguya ise sadece serum fizyolojik juguler ven yoluyla verildi. Serum total antioksidan kapasitesi (TAK) ve serum malondialdehit (MDA) düzeyleri ölçüldü. Aortic kross klemp yerleştirimeden önce ve kross klempin alınmasını takiben 60. dakikada akciğer biyopsisi alındı ve elektron mikroskopu altında histopatolojik olarak değerlendirildi. B Bu ul lg gu ul la ar r: : Serum MDA değerleri karşılaştırıldığında, T1 (kross klemp kaldırıldıktan 15 dakika sonra) ve T2 (kross klemp kaldırıldıktan 30 dakika sonra) değerleri kontrol grubunda, E vitamini grubunun değerlerine göre daha yüksek saptandı. Serum TAK değerleri karşılaştırıldığında, T1, T2 ve T3 (kross klemp kaldırıldıktan 60 dakika sonra) değerleri E vitamini grubunda, kontrol grubuna kıyasla daha yüksek saptandı. E vitamin grubunda histopatolojik hasarlanmanın, kontrol grubundakine göre daha az olduğu sapta...

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“…Evidence of cardioprotection was obtained in the context of cardiac surgery: in patients undergoing CABG, treatment with α-tocopherol improved the recovery of systolic and diastolic function [313]. Likewise, intracoronary administration of vitamin E (100 mg) at the end of aortic cross clamping reduced troponin-I release and lactate production [314]. However, a randomized trial failed to demonstrate a beneficial effect of intravenous superoxide dismutase on global or regional left ventricular function in patients who underwent PTCA for the treatment of acute myocardial infarction [315] and a recent large trial has shown that 600 IU of natural source vitamin E did not provide overall benefit for major cardiovascular events or affect total mortality [316].…”

Section: Interventions Which Interfere With the Mechanisms Of Ischemimentioning

confidence: 99%

Biochemical Basis of Ischemic Heart Injury and of Cardioprotective Interventions

Zucchi

Ghelardoni²,

Evangelista³

2007

CMC

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Cardioprotective interventions are defined as interventions able to increase myocardial resistance to ischemia. The authors approach the issue of cardioprotection on the basis of the present knowledge about the biochemical mechanisms responsible for the injury produced by myocardial ischemia or ischemia-reperfusion. Reversible and irreversible injury are distinguished. The former is largely accounted for by the direct consequences of reduced ATP synthesis, which causes decreased ATP phosphorylation potential, acidosis and phosphate accumulation. The biochemical mechanisms leading to irreversible injury include osmotic overload, production of toxic lipid metabolites, cytosolic calcium overload, and generation of reactive oxygen species, which lead to membrane disruption, mitochondrial dysfunction and possibly to the activation of apoptotic pathways. The major effect of the classical cardioprotective agents (nitrates, beta adrenergic antagonists, calcium channel blockers) consists in affecting ATP demand/supply ratio in such a way as to delay the decrease in ATP phosphorylation potential. Other drugs have been introduced, which allegedly interfere directly with the mechanisms responsible for irreversible ischemic injury. These include 3-ketoacyl-CoA tiolase inhibitors, modulators of intracellular calcium channels, ionic exchanger inhibitors, free radical scavengers, caspase inhibitors, purinergic agonists, K(+)(ATP) channel openers, and modulators of mitochondrial permeability transition. The results obtained with these substances in experimental models and in the clinical setting are discussed. Special attention is devoted to angiotensin converting enzyme inhibitors, whose direct cardioprotective properties has recently been demonstrated.

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The Effects of Intracoronary Administration of Vitamin E on Myocardial Ischemia-Reperfusion Injury During Coronary Artery Surgery

Abstract: Administration of vitamin E into the coronary arteries before removal of the aortic cross-clamp can reduce myocardial cell injury and protect the myocardium from ischemia-reperfusion injury.

Cited by 25 publications

References 17 publications

Myocardial ischemia/reperfusion-injury, a clinical view on a complex pathophysiological process

Myocardial ischemia/reperfusion-injury, a clinical view on a complex pathophysiological process

The Efficacy of Vitamin E in the Prevention of Lung Ischemia-Reperfusion Injury After Cardiopulmonary Bypass in Open Heart Surgery

Biochemical Basis of Ischemic Heart Injury and of Cardioprotective Interventions

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