Effects of adenosine supplementing cold blood cardioplegia on myocardial injury in patients undergoing mitral valve replacement / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effects of adenosine supplementing cold blood cardioplegia on myocardial injury in patients undergoing milral valve replacement(MVR).Methods Thirty ASA Ⅱ or Ⅲ patients aged 18-64 yr with a BMI of 18-24 kg/m2 undergoing elective MVR were randomly divided into 2 groups(n =15each)control group(C)and adenosine group(A).In group A myocardial arrest was produced by infusing adenosine 6 mg diluted in normal saline 20 ml through aortic root after aorta was cross-clamped followed by cold blood cardiaplegic solution 20 mg/kg.In group C asystole was produced with cold blood cardioplegic solution 20 ml/kg alone every 30 min.Blood samples were taken from central vein at 5 min before(T1)and 4 h after aortic crossclamping(T2)and 24 h after operation(T3)for determination of plasma cardiac troponin Ⅰ(cTnI)concentration and creatine kinase-MB(CK-MB)activity.The amount of cardioplegic solution infused,cardiac arrest induction time(from infusion of adenosine or cardioplegic solution to asystole shown by ECG),restoration of spontaneous heartbeat,the amount of dopamine administered during the 2 h after CPB and aortic cross-clamping time were recorded.Results Supplementation of cold blood cardioplegia with adenosine significantly reduced cardiac arrest induction time,the total amount of dopamine administered during the 2 h after CPB and plasma cTnl concentration and CK-MB activity in group A compared with group C.Conclusion Cold blood cardioplegia supplemented with adenosine can attenuate myocardial injury in patients undergoing MVR.