Role of leucocytes in free radical production during myocardial revascularisation

E. De Vecchi, R. Paroni, M. G. Pala, G. Di Credico, V. Agape, C. Gobbi, P. A. Bonini, G. Paolini, A. Grossi

Research output: Contribution to journalArticle

Abstract

Objective - To evaluate the role of leucocytes in free radical production in patients with depressed or normal ejection fraction undergoing coronary bypass. Design - Two randomised control trials. Setting - Tertiary care centre. Patients and interventions - In the first study, 22 patients with ejection fractions of ≤ 40% received blood cardioplegic reperfusion with (n = 11) or without (n = 11) leucocyte depletion. In the second study, 22 patients with ejection fractions ≤ 45% received either leucocyte depleted (n = 11) or blood cardioplegia (n = 11). Main outcome measures - Glutathione, hypoxanthine, and lipid peroxidation products were measured in coronary sinus blood and plasma before aortic cross clamping and at 0, 15, and 30 minutes after unclamping. Haemodynamic variables and creatine kinase MB isoenzymes were monitored on the first postoperative day. Comparison between treatments was performed on difference (Δ) between measurements at time 0 and at baseline, and on slopes obtained by fitting measurements after unclamping with a linear regression model. Results - At unclamping no difference in Δ for plasma glutathione redox ratio (oxidised/total glutathione, %) was observed between treated and control groups with low ejection fraction (Δ = 16 (SD 8.39) and 24 (7.0) redox ratio %, respectively). Baseline value recovery rate (redox ratio %/min) was significantly faster in treated υ control patients (slope -0.912 (0.380) υ -0.158 (0.200), P <0.005, respectively). Cardiac index showed a trend to greater improvement in the treated group (slope 0.04 (0.03) υ 0.003 (0.002) l/min/m2/h, P <0.02, treated υ controls, respectively). In patients with normal ejection fraction, leucocyte depletion did not result in significant improvement υ controls. Conclusions - Leucocyte depletion seems to provide benefit only in patients with left ventricular dysfunction.

Original languageEnglish
Pages (from-to)449-455
Number of pages7
JournalHeart
Volume77
Issue number5
Publication statusPublished - 1997

Keywords

  • Glutathione
  • Leucocyte depletion
  • Myocardial protection
  • Oxidative stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    De Vecchi, E., Paroni, R., Pala, M. G., Di Credico, G., Agape, V., Gobbi, C., Bonini, P. A., Paolini, G., & Grossi, A. (1997). Role of leucocytes in free radical production during myocardial revascularisation. Heart, 77(5), 449-455.