Myocardial protection of Shenmai injection in patients subject to beating-heart surgery

Abstract

Objective To evaluate the myocardial protective effects of Shenmai injection in patients udnergoing cardiopul-monary bypass (CPB) surgery on beating-heart.Methods Sixty patients with rheumatic heart disease preparing for mitral valve replacement were randomly divided into two groups:control group (group A,n =30) and experimental group (group B,n =30).The patients in group B were given Shenmai injection 0.6 ml/kg in circuit priming fluids,and those in group A were given equal volume of normal saline.Blood samples were collected before surgery (T1),at 30 min of CPB (T2),at the end of CPB (T3) and operation (T4),24 h after operation (T5),and 72 h after operation (T6) for assessment of lactate dehydrogenase (LDH),CK-MB,cardiac Troponin T (cTnT),superoxide dismutase (SOD) and malondialdehyde (MDA).Results (1) The levels of LDH were significantly lower in group B than in group A at T3 to T6 [(258.55 ± 21.83) U/L vs.(345.12 ± 25.28) U/L,(306.40 ± 26.11) U/L vs.(396.36 ± 22.66) U/L,(335.62 ± 26.72) U/L vs.(415.74 ± 39.56) U/L,(380.00 ± 31.53) U/L vs.(435.45 ±41.39) U/L] (P ＜0.05).The levels of CK-MB were significantly lower in group B than in group A at T2 to T5 [(33.70 ± 12.60) U/L vs.(42.31 ± 11.03) U/L,(48.91 ± 12.30) U/L vs.(78.81 ±15.03) U/L,(55.82±15.28) U/Lvs.(90.76±20.14) U/L,(73.09 ±24.34) U/Lvs.(109.05 ±24.33) U/L] (P ＜0.05).The levels of cTnT were significantly lower in group B than in group AatT2 to T6 [(0.89 ± 0.27) U/Lvs.(2.61 ±0.25) U/L,(5.49±1.79) U/Lvs.(11.48±2.41) U/L,(8.31 ±2.44) U/L vs.(18.34 ±3.76) U/L,(17.91 ±3.42) U/L vs.(27.05 ±4.24) U/L,(5.10 ± 1.42) U/L vs.(11.19 ±2.80) U/L] (P＜0.05).(2) The levels of SOD were significantly higher in group B than in group A at T2 to T6[(68.69 ±7.26) U/L vs.(55.22 ±7.30) U/L,(54.28 ±7.94) U/L vs.(35.11 ±6.61) U/L,(44.03 ±6.17) U/L vs.(25.41 ±3.98) U/L,(53.93 ±6.76) U/L vs.(41.60 ± 3.79) U/L,(64.27 ± 7.13) U/L vs.(50.02 ± 4.45) U/L] (P ＜ 0.05).The levels of MDA were significantly lower in group B than in group A at T2 to T6 [(4.38 ± 0.54) μmol/L vs.(6.97 ± 0.76) μmol/L,(6.13 ±0.65) μmol/L vs.(8.59 ±0.96) μmol/L,(8.02 ±0.95) μmol/L vs.(10.28 ±0.58) μmol/L,(5.78 ±0.63) μmol/L vs.(8.55 ±0.57) μmol/L,(4.53 ±0.51) μmol/L vs.(6.62 ± 0.55) μmol/L] (P ＜ 0.05).Conclusion Shenmai injection offers protective effect on myocardial ischemia-reperfusion injury during beating heart surgery,by increasing the activity of SOD and reducing the production of myocardial enzyme leak and MDA. Key words: Shenmai injection; Cardiopulmonary bypass ; Myocardial protection; Oxygen free radical