Correlation Between Cardiac Index, Plasma Troponin I, Myocardial Histopathology, CPB and AoX Duration in Glutamine versus No Glutamine Administered Patients with Low Ejection Fraction Undergoing Elective On-Pump CABG Surgery: Secondary Analysis of an RCT.

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE Vascular Health and Risk Management Pub Date : 2023-01-01 DOI:10.2147/VHRM.S399925

I Made Adi Parmana, Cindy Elfira Boom, Lisnawati Rachmadi, Dudy Arman Hanafy, Yunita Widyastuti, Muchtaruddin Mansyur, Bambang Budi Siswanto

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Abstract

Purpose: On-pump coronary artery bypass graft (CABG) causes myocardial ischemia, through the cardiopulmonary bypass (CPB) and aortic cross-clamping (AoX). Glutamine supplementation protects cardiac cells during cardiac ischemia. This study analysed the correlation between cardiac index (CI), plasma troponin I, myocardial histopathology, CPB and AoX duration in low ejection fraction patients receiving glutamine and no glutamine undergoing elective on-pump CABG.

Material and methods: This was a secondary analysis of a double-blind, randomised controlled trial of 60 patients, split into control and intervention (glutamine) groups. Glutamine was administered at a dose of 0.5 g/kg/24 hours. There were 29 patients in each respective groups after a total of two patients dropped out.

Results: A negative correlation (p = 0.037) was observed between CPB duration and CI at 6 hours after CPB in the glutamine group. A positive correlation (p = 0.002) was also observed between AoX duration and plasma troponin I at 6 hours after CPB in the control group. However, no correlation was observed between myocardial histopathology and plasma troponin I level at 5 minutes after CPB.

Conclusion: Significant negative correlation between CPB duration and CI at 6 hours after CPB in the glutamine group, along with significant positive correlation between AoX duration and plasma troponin I level at 6 hours after CPB in the control group demonstrated the myocardial protection qualities of intravenous glutamine administration in patients with low ejection fraction undergoing elective on-pump CABG surgeries.

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谷氨酰胺治疗与不使用谷氨酰胺治疗的低射血分数CABG选择性手术患者心脏指数、血浆肌钙蛋白I、心肌组织病理学、CPB和AoX持续时间的相关性:一项随机对照试验的二次分析

目的:无泵冠状动脉旁路移植术(CABG)通过体外循环(CPB)和主动脉交叉夹持(AoX)引起心肌缺血。谷氨酰胺补充保护心肌细胞在心脏缺血。本研究分析了接受谷氨酰胺治疗和不接受谷氨酰胺治疗的低射血分数患者行选择性非泵上冠状动脉绕道手术时心脏指数(CI)、血浆肌钙蛋白I、心肌组织病理学、CPB和AoX持续时间的相关性。材料和方法:这是对60例患者的双盲随机对照试验的二次分析，分为对照组和干预组(谷氨酰胺)。谷氨酰胺给药剂量为0.5 g/kg/24小时。两名患者退出后，每组29名患者。结果:谷氨酰胺组CPB持续时间与CPB后6 h CI呈负相关(p = 0.037)。对照组CPB后6小时AoX持续时间与血浆肌钙蛋白I呈正相关(p = 0.002)。然而，CPB后5分钟心肌组织病理学与血浆肌钙蛋白I水平无相关性。结论:谷氨酰胺组CPB持续时间与CPB后6小时CI呈显著负相关，对照组AoX持续时间与CPB后6小时血浆肌钙蛋白I水平呈显著正相关，说明静脉注射谷氨酰胺对低射血分数选择性非泵CABG患者的心肌保护效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.