Abstract | BACKGROUND: METHODS: Pigs were subjected to 30 minutes of regional myocardial ischemia by distal left anterior descending coronary artery occlusion, followed by 60 minutes of cardiopulmonary bypass with 45 minutes of cardioplegic arrest and 90 minutes of post- cardiopulmonary bypass reperfusion. The treatment group (n = 6) was administered aprotinin systemically (40,000 kallikrein-inhibiting units [KIU]/kg intravenous loading dose, 40,000 KIU/kg pump prime, and 10,000 KIU x kg(-1) x h(-1) intravenous continuous infusion). Control animals (n = 6) received crystalloid solution. Global and regional myocardial functions were analyzed by the left ventricular+dP/dt and the percentage segment shortening, respectively. Left ventricular infarct size was measured by tetrazolium staining. Tissue myeloperoxidase activity was measured. Myocardial sections were immunohistochemically stained for nitrotyrosine. Coronary microvessel function was studied by videomicroscopy. RESULTS:
Myocardial infarct size was decreased with aprotinin treatment (27.0% +/- 3.5% vs 45.3% +/- 3.0%, aprotinin vs control; P <.05). Myocardium from the ischemic territory showed diminished nitrotyrosine staining in aprotinin-treated animals versus controls, and this was significant by grade (1.3 +/- 0.2 vs 3.2 +/- 0.2, aprotinin vs control; P <.01). In the aprotinin group, coronary microvessel relaxation improved most in response to the endothelium-dependent agonist adenosine diphosphate (44.7% +/- 3.2% vs 19.7% +/- 1.7%, aprotinin vs control; P <.01). No significant improvements in myocardial function were observed with aprotinin treatment. CONCLUSIONS:
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Authors | Tanveer A Khan, Cesario Bianchi, Pierre Voisine, Jun Feng, Jeralyn Baker, Melanie Hart, Minoru Takahashi, Greg Stahl, Frank W Sellke |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 128
Issue 4
Pg. 602-8
(Oct 2004)
ISSN: 0022-5223 [Print] United States |
PMID | 15457162
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Serine Proteinase Inhibitors
- Aprotinin
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Topics |
- Animals
- Aprotinin
(therapeutic use)
- Coronary Circulation
- Heart Arrest, Induced
- Microcirculation
(physiology)
- Myocardial Infarction
(prevention & control)
- Myocardial Ischemia
(physiopathology)
- Myocardial Reperfusion Injury
(prevention & control)
- Serine Proteinase Inhibitors
(therapeutic use)
- Swine
- Time Factors
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