Artículos de revistas
Trimetazidine As Cardioplegia Addictive Without Pre-treatment Does Not Improve Myocardial Protection: Study In A Swine Working Heart Model [trimetazidina Como Aditivo Em Solução Cardioplégica Sem Pré-tratamento Não Traz Proteção Adicional Ao Miocárdio Isquêmico: Estudo Em Modelo Suíno De Coração Isolado]
Registro en:
Brazilian Journal Of Cardiovascular Surgery. , v. 23, n. 2, p. 224 - 234, 2008.
1027638
2-s2.0-53049106592
Autor
Silveira Filho L.D.M.
Petrucci Jr. O.
Do Carmo M.R.
De Oliveira P.P.M.
Vilarinho K.A.S.
Vieira R.W.
Braile D.M.
Institución
Resumen
Objective: The aim of this study is to verify in an isolated working heart swine model if the acute administration of trimetazidine to cardioplegia, without pre=treatment improves heart performance. Methods: Eighteen pairs of swines were used in this working heart model, divided into three groups (n = 6) that underwent regional and global ischemia. Each group was selected to a different treatment: St Thomas cardioplegia (ST), St Thomas enriched with trimetazidine (TMZ) and control group (Co). Data was collected during reperfusion period at 30, 60 and 90 minutes. Hemodinamic parameters such as elastance contractility index (Emax), preload recruitable stroke work relationship (PRSW) and heart "stiffness" (EDPVR) were measured. Other data included coronary flow, lactate, oxygen and glucose consumption. Results were statistically analyzed. Results: All contractility data were not significantly different among three groups. Lactate became constantly higher according to time uniformly in all three groups. Coronary flow, glucose consumption and oxygen consumption presented large variations during time periods but according to treatments showed no statistical differences in all three groups. Left ventricle final weight was significantly lower in trimetazidine group compared to both other groups. Conclusion: Administration of trimetazidine enhanced cardioplegia, without pre-treatment, showed no hemodinamic or metabolic improvement in swine isolated working heart model. 23 2 224 234 Desideri, A., Celegon, L., Metabolic management of ischemic heart disease: Clinical data with trimetazidine (1998) Am J Cardiol, 82 (5 A), pp. 50K-53K Lavanchy, N., Martin, J., Rossi, A., Anti-ischemic effects of trimetazidine: 31P-NMR spectroscopy in the isolated rat heart (1987) Arch Int Pharmacodyn Ther, 286 (1), pp. 97-110 Belardinelli, R., Trimetazidine and the contractile response of dysfunctional myocardium in ischaemic cardiomiopathy (2000) Rev Port Cardiol, 19 (SUPPL. 5), pp. V35-V39 Knight, C., Fox, K., From antianginal drugs to myocardial cytoprotective agents (1995) Am J Cardiol, 76 (6), pp. 4B-7B Stanley, W.C., Changes in cardiac metabolism: A critical step from stable angina to ischaemic cardiomiopathy (2001) Eur Heart J, 3 (SUPPL.), pp. 2-7 Fabiani, J.N., Ponzio, O., Emerit, I., Massonet-Castel, S., Paris, M., Chevalier, P., Cardioprotective effect of trimetazidine during coronary artery graft surgery (1992) J Cardiovasc Surg, 33 (4), pp. 486-491 Vedrinne, J.M., Vedrinne, C., Bompard, D., Lehot, J.J., Boissel, J.P., Champsaur, G., Myocardial protection during coronary artery bypass graft surgery: A randomized, double-blind, placebo-controlled study with trimetazidine (1996) Anaesth Analg, 82 (4), pp. 712-718 Tünerir, B., Colak, O., Alatas, O., Besogul, Y., Kural, T., Aslan, R., Measurement of troponin T to detect cardioprotective effect of trimetazidine during coronary artery bypass grafting (1999) Ann Thorac Surg, 68 (6), pp. 2173-2176 Colégio Brasileiro de Experimentação Animal. Princípios éticos na experimentação animal. In: São Paulo:Congresso do Colégio Brasileiro de Experimentaç ão Animal 1991Budrikis, A., Bolys, R., Liao, Q., Ingemansson, R., Sjöberg, T., Steen, S., Function of adult pig hearts after 2 and 12 hours of cold cardioplegic preservation (1998) Ann Thorac Surg, 66 (1), pp. 73-78 Brooks, W.W., Healey, N.A., Sen, S., Conrad, C.H., Bing, O.H., Oxygen cost of stress development in hypertrophied and failing hearts from the spontaneously hypertensive rat (1993) Hypertension, 21 (1), pp. 56-64 Petrucci Jr O. Estudo comparativo entre solução cardioplégica cristalóide e microcardioplegia sanguínea normotérmica em corações agudamente isquêmicos [Tese de Doutorado]. Campinas:Universidade Estadual de Campinas;2004Detry, J.M., Leclercq, P.J., Trimetazidine European Multicenter Study versus propranolol in stable angina pectoris: Contribution of Holter electrocardiographic ambulatory monitoring (1995) Am J Cardiol, 76 (6), pp. 8B-11B Marzilli, M., Klein, W.W., Efficacy and tolerability of trimetazidine in stable angina: A meta-analysis of randomized, double-blind, controlled trials (2003) Coron Artery Dis, 14 (2), pp. 171-179 Cesar, L.A.M., Dallan, L.A., Gowdak, L.H.W., Lisboa, L.A.F., Moretti, M.A., Alternatives for the treatment of angina pectoris: New drugs, external counterpulsation, spinal-cord stimulation for analgesia, therapeutic angiogenisis and transmyocardial revascularization (2003) Rev Soc Cardiol Estado de São Paulo, 13 (2), pp. 240-253 Braile, D.M., Cardioplegia sanguínea isotérmica anterógrada e retrógrada de baixo volume (1997) São José do Rio Preto Herrmann, J.L.V., Stefanini, E., Drug therapy. Choosing the best schedule (2003) Rev Soc Cardiol Estado de São Paulo, 13 (2), pp. 196-203 Stanley, W.C., Cardiac energetics during ischemia and the rationale for metabolic interventions (2001) Coron Artery Dis, 12 (SUPPL. 1), pp. 53-57 Pichon, G., Rousseau, D., Helies, C., Control by Trimetazidine of the energy substrate balance in ventricular myocite (1999) J Moll Cell Cardiol, 31, pp. A88 Rodrigues, A.J., Vicente, W.V.A., Carneiro, J.J., Bassetto, S., Cardioplegia sanguínea anterógrada intermitente normotérmica e hipotérmica: Estudo comparativo em corações agudamente isquêmicos de coelhos. (2000) Rev Bras Cir Cardiovasc, 15 (3), pp. 238-250 Rodrigues, A.J., Sader, A.A., Vicente, W.V.A., Bassetto, S., Cardioplegia sanguínea normotérmica intermitente anterógrada. II. Com e sem aminoácidos: Estudo comparativo em coelhos. (1997) Rev Bras Cir Cardiovasc, 12 (4), pp. 340-347 Horsley, W.S., Whitlark, J.D., Hall, J.D., Gott, J.P., Huang, P.-C.A.H., Revascularization for acute regional infarct: Superior protection with warm blood cardioplegia (1993) Ann Thorac Surg, 56 (6), pp. 1228-1237 Grossman, W., Braunwald, E., Mann, T., McLaurin, L.P., Green, L.H., Contractile state of the left ventricle in man as evaluated from end-systolic pressure-volume relations (1977) Circulation, 56 (5), pp. 845-852 Glower, D.D., Spratt, J.A., Snow, N.D., Kabas, J.S., Davis, J.W., Olsen, C.O., Linearity of the Frank-Starling relationship in the intact heart: The concept of preload recruitable stroke work (1985) Circulation, 71, pp. 994-1009 Guyton RA. A synopsis of cardiac physiology. In: Edmunds LH. Cardiac surgery in the adult. 1st ed. New York:McGrawHill Companies;1997. p.59-84Petrucci Júnior, O., Oliveira, P.P., Carmo, M.R., Vieira, R.W., Braile, D.M., Standardization of an isolated pig heart preparation with parabiotic circulation: Methodological considerations (2003) Braz J Med Biol Res, 36 (5), pp. 649-659 Allibardi, S., Chierchia, S.L., Margonato, V., Merati, G., Neri, G., Dell'Antonio, G., Effects of trimetazidine on metabolic and functional recovery of postischemic rat hearts (1998) Cardiovasc Drugs Ther, 12 (6), pp. 543-549 Kantor, P.F., Lucien, A., Kozak, R., Lopaschuk, G.D., The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase (2000) Circ Res, 86 (5), pp. 580-588 Kober, G., Buck, T., Sievert, H., Vallbracht, C., Myocardial protection during percutaneous transluminal coronary angioplasty: Effects of trimetazidine (1992) Eur Heart J, 13 (8), pp. 1109-1115 Beygui, F., Trimetazidine as adjunctive therapy to primary PTCA for acute myocardial infarction (2000) Rev Port Cardiol, 19 (SUPPL. 5), pp. V31-V34 Steg, P.G., Grollier, G., Gallay, P., Morice, M., Karrillon, G.J., Benamer, H., A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction (2001) Int J Cardiol, 77 (2-3), pp. 263-273 Group. Effect of 48-h intravenous trimetazidine on short- and long-term outcomes of patients with acute myocardial infarction, with and without thrombolitic therapy A double-blind, placebo-controlled, randomized trial. The EMIP-FR Group. European Myocardial Infarction Project-Free Radicals (2000) Eur Heart J, 21 (18), pp. 1537-1546. , The European Myocardial Infarction Project-Free Radicals EMIP-FR Grynberg, A., The EMIP-FR Study: The evolution of scientific background as a non-controlled parameter (2001) Eur Heart J, 22 (11), pp. 975-977 Ikizler, M., Erkasap, N., Dernek, S., Batmaz, B., Kural, T., Kaygisiz, Z., Trimetazidine-induced enhancement of myocardial recovery during reperfusion: A comparative study in diabetic and non-diabetic rat hearts (2006) Arch Med Res, 37 (6), pp. 700-708 Ikizler, M., Dernek, S., Sevin, B., Kural, T., Trimetazidine improves recovery during reperfusion in isolated rat hearts after prolonged ischemia (2003) Anadolu Kardiyol Derg, 3 (4), pp. 303-308 Onay-Besikci, A., Guner, S., Arioglu, E., Ozakca, I., Ozcelikay, A.T., Altan, V.M., The effects of chronic trimetazidine treatment on mechanical function and fatty acid oxidation in diabetic rat hearts (2007) Can J Physiol Pharmacol, 85 (5), pp. 527-535