Protective effect of nicorandil on myocardial ischemia reperfusion injury in patients undergoing cardiac valve replacement / 中国临床药理学与治疗学

ABSTRACT

AIM:To observe the protective effect of nicorandil on myocardial ischemia reperfusion injury in patients undergoing valve replacement.METHODS:Sixty patients undergoing valve repalacement were randomly divided into 3 groups:control(Ⅰ)group,nicorandil delayed precondictioning(Ⅱ)group and nicorandil preconditioning(Ⅲ)group.20 mg nicorandil was given i.v.24 h before operation in group Ⅱ,whereas in group Ⅲ,20 mg nicorandil was given i.v.after induction of anesthesia.Blood samples were taken from coronary venous for determination of cTnI,TNF-?,IL-6 levels at aortic clamping(T0),15 min(T1),30 min(T2),60 min(T3),90 min(T4)after aortic declamping.Right atria myocardium tissue were taken at T0 and T2 to observe the histopathological changes with electron microscopy.RESULTS:The levels of cTnI,TNF-?and IL-6 in group Ⅱand Ⅲ were significantly lower than those in group I.Myocardium injury was obviously lighter in groupⅡand Ⅲ than that in group Ⅰ,whereas the levels of cTnI,TNF-?,IL-6 and myocardium injury were lower in group Ⅱ than those in group Ⅲ.CONCLUSION:Nicorandil is effcetive in decreasing myocardial ischemia repefusion injury in patients undergoing valve replacement,The protective effect of nicorandil delayed preconditioning is more obvious than precondictioning.