Effects of ischaemic postconditioning in aortic valve replacement: a multicenter randomized controlled trial
| العنوان: | Effects of ischaemic postconditioning in aortic valve replacement: a multicenter randomized controlled trial |
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| المؤلفون: | Marte Wennemo, Mikhail Gordeev, Øyvind Jakobsen, Mikhail Galagudza, Kathrine Nergaard Aas, Cathrine Brunborg, Paweł Czub, Adam Arendarczyk, Mari-Liis Kaljusto, Torvind Næsheim, Jarle Vaage, Andrey Bautin, Lyudmila Karpova, Radosław Wilimski, Svein Aslak Landsverk |
| المصدر: | European Journal of Cardio-Thoracic Surgery. 61:1144-1152 |
| بيانات النشر: | Oxford University Press (OUP), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, Pulmonary and Respiratory Medicine, Cardiac function curve, Cardiac output, Mean arterial pressure, medicine.medical_specialty, Cardiac index, Aortic valve replacement, Internal medicine, medicine, Creatine Kinase, MB Form, Humans, Prospective Studies, Ischemic Postconditioning, Heart Valve Prosthesis Implantation, Troponin T, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Treatment Outcome, Aortic Valve, Ventricular fibrillation, Heart Arrest, Induced, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business |
| الوصف: | OBJECTIVES The effect of ischaemic postconditioning (IPost) on postcardioplegic cardiac function is not known. We hypothesized that IPost was cardioprotective in adult patients undergoing elective aortic valve replacement. METHODS In a multicentre, prospective, randomized trial, patients (n = 209) were randomized to either a standard operation (controls) or postconditioning. Immediately before the cross-clamp was released, patients in the postconditioning group underwent 3 cycles of flow/non-flow (2 min each) of normothermic blood via the antegrade cardioplegia line. The primary end point was cardiac index. Secondary end points included additional haemodynamic measurements, biomarkers of cardiomyocyte injury, renal function parameters, intra- and postoperative arrhythmias and use of inotropic agents. RESULTS There was no significant difference between the groups regarding cardiac index [mean between-group difference, 95% confidence interval (CI), 0.11 (−0.1 to 0.3), P = 0.27]. Postconditioning had no effect on other haemodynamic parametres. There was no between-group difference regarding troponin T or creatine kinase MB. Postconditioning reduced the relative risk for arrhythmias by 45% (P = 0.03) when postoperative atrial fibrillation and intraoperative ventricular fibrillation were combined. There were no differences in patients with/without diabetes, patients above/below 70 years of age or between the centres. However, after postconditioning, the cardiac index [95% CI, 0.46 (0.2–0.7), P = 0.001], cardiac output (P CONCLUSIONS IPost had no overall cardioprotective effects in patients undergoing aortic valve replacement but improved postoperative cardiac performance in men compared to women. |
| تدمد: | 1873-734X 1010-7940 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::55cc3d80e254f42e24c849d7de9960faTest https://doi.org/10.1093/ejcts/ezab500Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....55cc3d80e254f42e24c849d7de9960fa |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1873734X 10107940 |
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