Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery
BackgroundCardioplegic arrest during the heart valve replacement surgery frequently leads to myocardial damage. Tropisetron (TRP) has been demonstrated to reduce myocardial ischemia-reperfusion injury and inflammation in animals. We examined the efficacy of TRP in lowering myocardial biomarkers in p...
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Frontiers Media S.A.
2022-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.690272/full |
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| author | Di Yu Di Yu Xingrui Gong Yufei Zhang Qing Li Mazhang Zhang |
| author_facet | Di Yu Di Yu Xingrui Gong Yufei Zhang Qing Li Mazhang Zhang |
| author_sort | Di Yu |
| collection | DOAJ |
| description | BackgroundCardioplegic arrest during the heart valve replacement surgery frequently leads to myocardial damage. Tropisetron (TRP) has been demonstrated to reduce myocardial ischemia-reperfusion injury and inflammation in animals. We examined the efficacy of TRP in lowering myocardial biomarkers in patients undergoing heart valve replacement surgery.MethodsA total of seventy-five patients, scheduled for elective heart valve replacement surgery, were randomly chosen to receive either 10 ml of normal saline or 10 mg/10 ml of TRP immediately after anesthesia induction. Blood samples for the measurement of cardiac troponin I (cTnI), creatine kinase (CK-MB), lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-10 (IL-10) were taken before anesthesia, as well as 4, 12, and 24 h after aortic cross-clamp release to evaluate myocardial injury using two-way ANOVA for repeated measurements. The study was registered at www.chictr.org.cn (number, ChiCTR-1800018681).ResultsTreatment with TRP decreased the increment of cTnI (Fgroup = 4.911, p = 0.030; Ftime = 55.356, p = 0.001; Fgroup × time = 5.340, p = 0.002) at 12 and 24 h; of CK-MB (Fgroup = 6.552, p = 0.013; Ftime = 49.276, p = 0.001; Fgroup × time = 7.627, p = 0.003) at 4, 12, and 24 h; of TNF-α (Fgroup = 4.153, p = 0.046; Ftime = 28.244, p = 0.002; Fgroup × time = 4.692, p = 0.006) at 4 and 12 h; and of LDH (Fgroup = 4.275, p = 0.043; Ftime = 63.225, p = 0.001; Fgroup × time = 2.501, p = 0.083) at 24 h after the release of the aortic cross-clamp. It increased IL-10 (Fgroup = 5.958, p = 0.018; Ftime = 31.226, p = 0.002; Fgroup × time = 1.464, p = 0.236) at 12 h after the release of the aortic cross-clamp. Multiple linear regression analysis showed that cardiopulmonary bypass (CPB) time was a risk factor, and that TRP treatment was a protective factor for postoperative cTNI change (β = 4.449, 95% CI [0.97–7.92], p = 0.013 for CPB time; and β = −381, 95% CI [−613.4 to −148.5], p = 0.002 for TRP treatment).ConclusionsTropisetron had cardioprotective and anti-inflammatory effects in patients undergoing heart valve replacement surgery with cardioplegic arrest. The addition of TRP and reduction of CPB time should be considered for myocardial protection in heart valve replacement surgery.Clinical Trial Registration[www.chictr.org.cn/index.aspx], identifier [ChiCTR1800018681]. |
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| spelling | doaj.art-43385c55747a4fc9b88503e8c7cf49d12022-12-22T02:40:59ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.690272690272Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement SurgeryDi Yu0Di Yu1Xingrui Gong2Yufei Zhang3Qing Li4Mazhang Zhang5Department of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaHubei No. 3 People’s Hospital of Jianghan University, Wuhan, ChinaDepartment of Anesthesiology, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaDepartment of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaDepartment of Anesthesiology, Shanghai Children’ Medical Central, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackgroundCardioplegic arrest during the heart valve replacement surgery frequently leads to myocardial damage. Tropisetron (TRP) has been demonstrated to reduce myocardial ischemia-reperfusion injury and inflammation in animals. We examined the efficacy of TRP in lowering myocardial biomarkers in patients undergoing heart valve replacement surgery.MethodsA total of seventy-five patients, scheduled for elective heart valve replacement surgery, were randomly chosen to receive either 10 ml of normal saline or 10 mg/10 ml of TRP immediately after anesthesia induction. Blood samples for the measurement of cardiac troponin I (cTnI), creatine kinase (CK-MB), lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-10 (IL-10) were taken before anesthesia, as well as 4, 12, and 24 h after aortic cross-clamp release to evaluate myocardial injury using two-way ANOVA for repeated measurements. The study was registered at www.chictr.org.cn (number, ChiCTR-1800018681).ResultsTreatment with TRP decreased the increment of cTnI (Fgroup = 4.911, p = 0.030; Ftime = 55.356, p = 0.001; Fgroup × time = 5.340, p = 0.002) at 12 and 24 h; of CK-MB (Fgroup = 6.552, p = 0.013; Ftime = 49.276, p = 0.001; Fgroup × time = 7.627, p = 0.003) at 4, 12, and 24 h; of TNF-α (Fgroup = 4.153, p = 0.046; Ftime = 28.244, p = 0.002; Fgroup × time = 4.692, p = 0.006) at 4 and 12 h; and of LDH (Fgroup = 4.275, p = 0.043; Ftime = 63.225, p = 0.001; Fgroup × time = 2.501, p = 0.083) at 24 h after the release of the aortic cross-clamp. It increased IL-10 (Fgroup = 5.958, p = 0.018; Ftime = 31.226, p = 0.002; Fgroup × time = 1.464, p = 0.236) at 12 h after the release of the aortic cross-clamp. Multiple linear regression analysis showed that cardiopulmonary bypass (CPB) time was a risk factor, and that TRP treatment was a protective factor for postoperative cTNI change (β = 4.449, 95% CI [0.97–7.92], p = 0.013 for CPB time; and β = −381, 95% CI [−613.4 to −148.5], p = 0.002 for TRP treatment).ConclusionsTropisetron had cardioprotective and anti-inflammatory effects in patients undergoing heart valve replacement surgery with cardioplegic arrest. The addition of TRP and reduction of CPB time should be considered for myocardial protection in heart valve replacement surgery.Clinical Trial Registration[www.chictr.org.cn/index.aspx], identifier [ChiCTR1800018681].https://www.frontiersin.org/articles/10.3389/fmed.2022.690272/fulltropisetronheart surgerymyocardial injuryα7 nACh receptorinflammation |
| spellingShingle | Di Yu Di Yu Xingrui Gong Yufei Zhang Qing Li Mazhang Zhang Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery Frontiers in Medicine tropisetron heart surgery myocardial injury α7 nACh receptor inflammation |
| title | Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery |
| title_full | Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery |
| title_fullStr | Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery |
| title_full_unstemmed | Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery |
| title_short | Tropisetron Preconditioning Decreases Myocardial Biomarkers in Patients Undergoing Heart Valve Replacement Surgery |
| title_sort | tropisetron preconditioning decreases myocardial biomarkers in patients undergoing heart valve replacement surgery |
| topic | tropisetron heart surgery myocardial injury α7 nACh receptor inflammation |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.690272/full |
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