Effect Of Pharmacological Adenosine Postconditioning On Myocardial Protection In Patients Under Cardiopulmonary Bypass

Objective: To observe the effect of adenosine postconditioning on myocardial protection.Methods: Forty-five patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB) were randomized into three matched groups with 15 cases each. Group A received adenosine before CPB, group B received exogenous adenosine by cardioplegia solution or aortic cannula after first cardioplegia, and group C normal saline instead adenosine. Blood samples were taken to determine the serum concentrations of creatine isoenzyme(CK-MB), calcitonin-I(cTn-I) and malondialdehyde(MDA) before CPB, at 2, 6 and 16 h after opening aortic clamp.Results: The levels of cTn-I after surgery and CK-MB at 2 h,MDA at 6 h after opening aortic clamp were significantly lower in group A than those in group C, the levels of 2,6 h CK-MB, cTn-I and MDA after opening aortic clamp in group B were significantly lower than those in group C, which were not significantly different between grop A and B. Conclution: Exogenous adenosine postconditioning has the same myocardial protective effect as adenosine preconditioning in open heart surgical patients under CPB.