Cardiopulmonary Bypass, Ischemic Postconditioning
Conditions
Brief summary
1. Cardiopulmonary bypass and cardioplegic arrest could regulate expression of microRNAs in patients undergoing double valve replacement (aortic and mitral). 2. The modulation of myocardial microRNAs by cardiopulmonary bypass and cardioplegic arrest may be rescued by ischemic postconditioning. 3. Downstream effectors would also be affected.
Interventions
PROCEDUREischemic postconditioning
multiple brief ischemic-reperfusion episodes immediately after sustained ischemic insult Postconditioning was started at 30 s after aortic cross declamping, and the aorta was re-clamped for 30 s rendering global myocardial ischemia. Meanwhile aortic root suction was established during aortic re-clamping, and thereafter, the aortic clamp was released for 30 s for full myocardial reperfusion. The cycle was repeated three times after cardioplegic arrest.
PROCEDUREdouble valve replacement
The double valve replacement is a procedure in which surgery is used to replace diseased aortic and mitral heart valves.
DEVICEheart-lung machine
The heart-lung machine is commonly used in open heart surgery including double valve replacement to support the circulation during the operation.
DEVICEAortic cross-clamp
a surgical instrument used in cardiac surgery to clamp the aorta
Sponsors
Central South University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Consecutive eight patients with rheumatic heart valve disease undergoing elective double valve replacement(aortic and mitral)are considered for participation in this study.
Exclusion criteria
* insulin-dependent diabetes mellitus * pulmonary, renal, or hepatic failure * infective valve disease * valve disease with coronary artery disease * hypertension * emergency and reoperations * received aspirin,corticosteroids, or statin preoperatively * received preoperative inotropic support
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Cardiac MicroRNA Expression | before cardiopulmonary bypass and at 5 min after aortic de-clamping | Samples were harvested from all the patients, respectively, before cardiopulmonary bypass and at 5 min after aortic de-clamping. Real-time quantitative stem-loop reverse transcription polymerase chain reaction assay was performed to detect the expression of microRNAs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Downstream Gene Expression | before cardiopulmonary bypass and at 5 min after aortic de-clamping | Expressions of messenger RNAs and proteins were quantified for genes which are regulated by above-detected microRNAs. |
Countries
China
Outcome results
None listed