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Eur Heart J. 2004 Nov 30; [Epub ahead of print] Related Articles, Links


Deferoxamine infusion during coronary artery bypass grafting ameliorates lipid
peroxidation and protects the myocardium against reperfusion injury: immediate
and long-term significance.

Paraskevaidis IA, Iliodromitis EK, Vlahakos D, Tsiapras DP, Nikolaidis A,
Marathias A, Michalis A, Kremastinos DT.

2nd Department of Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou
Avenue, 176 74 Athens, Greece.

AIMS: Previous reports have demonstrated enhanced myocardial protection and
better post-ischaemic recovery using the oxygen free radical scavenger
deferoxamine (DEF) during cardioplegia. The aim of this study was to test
whether, in patients undergoing coronary artery bypass grafting (CABG), DEF
i.v. infusion can reduce reperfusion injury on a short- and long-term basis.
METHODS AND RESULTS: Forty-five consecutive male patients were randomly
allocated to two groups: in group D (n = 25, age 60.8 +/- 8.6 years), 4g of DEF
were infused for 8 h starting immediately after the induction of anaesthesia;
in group C (n = 20, age 62.2 +/- 6.4 years) dextrose solution was given for the
same time as placebo. Haemodynamic monitoring and measurement of oxygen free
radical production [by measuring thiobarbituric acid reactive substances
(TBARS)] were carried out before and after CABG. Left ventricular ejection
fraction (EF) and wall motion score index (WMSI) were measured before and after
CABG and 12 months later. Haemodynamic measurements were similar in both groups
before and after CABG. TBARS peaked at 4.8 +/- 1.1nmol/mL in group C, but
remained unchanged (2.4 +/- 0.9nmol/mL) in group D (P = 0.01). At baseline,
both the EF and WMSI were similar between the groups. Following CABG, EF
increased more in group D (8.8 +/- 8.4%) than in group C (1.3 +/- 6.7%), P =
0.008, while WMSI decreased more in group D (-0.7 +/- 0.3) than in group C
(-0.2 +/- 0.2), P = 0.0001. Dividing group D according to the pre-operative
median EF value (38%), we observed that after 1 year follow-up, DEF infusion
conferred more protection in patients with a lower EF (EF increased by 19.3 +/-
6.2%, WMSI decreased by -1.1 +/- 0.2) than in those with a higher EF (EF
increased by 7.7 +/- 4.5%, WMSI decreased by -0.8 +/- 0.2), P = 0.001,
respectively. CONCLUSION: In patients undergoing CABG, DEF i.v. infusion
ameliorates oxygen free radical production and protects the myocardium against
reperfusion injury. Patients with a lower EF seem to benefit more by DEF i.v.
infusion.

PMID: 15618054 [PubMed - as supplied by publisher]

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