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Ann Thorac Surg 1994;57:1522-1525
© 1994 The Society of Thoracic Surgeons

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Articles

Blood cardioplegia reduces oxidant burden in the ischemic and reperfused human myocardium

Istituto di Fisiopatologia Medica and Cattedra di Cardiochirurgia, Universita' "G. D'Annunzio," Facolta' di Medicina e Chirurgia, Chieti, Italy

Accepted for publication September 30, 1993.

^_* Address reprint requests to Dr Lapenna, c/o Presidenza Fscolta' di Medidna e Chirurgia, Via del Vestini, 66100 Chieti, Italy.

In 20 patients receiving cold crystalloid caidioplegia (n = 10) or cold blood cardioplegia (n = 10) during elective coronary artery bypass grafting, the atrial myocardium was tested for glutathione-related antioxidant defenses and lipid pemxidation. In both groups, ischemia and reperfusion induced a significant increase in lipid peroxdation values (p < 0.05) that was associated with a depression of nonprotein thiol compound levels (p < 0.05). Compared with the cold crystalloid cardioplegiatreated patients, the cold blood cardioplegia-treated patients showed a lower lipid peroxidation (p < 0.05) and higher values of nonprotein thiol compounds (p < 0.05). Moreover, a significant ischemia and reperfusiondependent activation of glutathione transferase was oberved only in the cold crystalloid cardioplegia-treated patients. Selenium-dependent glutathione peroxidase and glutathione reductase activities did not change after release of the aortic cross-clamp and did not differ between the two groups. The highest postoperative plasma level of the myocardial-spetific isoenzyme of creatine kinase was significantly more elevated in the cold crystalloid cardioplegia patients. Overall, these tissue biochemical features indicate a lower oxidanl burden in the myocardium of cold blood cardioplegia-treated patients, a finding suggesting superior protection for the ischemic and reperfused human myocardium also through antioxldant-type mechanisms, apparently mediated by the antioxidant capacity of erythrocytes and specific plasma molecules.

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