L-carnitine on myocardial function after coronary artery bypass grafting

Yılmaz, Mustafa; FURAT, Cevdet; GÜVENER, Murat; BAYAR, Ekrem; İLHAN, Gökhan; Bozok, Şahin

L-carnitine on myocardial function after coronary artery bypass grafting

Cevdet FURAT, (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Gökhan İLHAN, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, Rize, Türkiye)

Ekrem BAYAR, (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Şahin BOZOK, (Bahçeşehir Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Murat GÜVENER, (Hacettepe Üniversitesi Tıp Fakültesi,Göğüs-Kalp ve Damar Cerrahisi Kliniği)

Mustafa YILMAZ (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

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Yıl: 2018 Cilt: 26 Sayı: 1 Sayfa Aralığı: 22 - 29 Metin Dili: İngilizce İndeks Tarihi: 19-11-2018

L-carnitine on myocardial function after coronary artery bypass grafting

Öz:

Background: This study aims to evaluate the effect of L-carnitine on postoperative cardiac performance and morbidity and complications in patients undergoing coronary artery bypass grafting.Methods: Between April 2005 and June 2008, a total of 60 patients (36 males, 24 females; mean age 60.6 years; range 57 to 65) who were scheduled for coronary artery bypass grafting were prospectively randomized to receive one of three different strategies of myocardial preservation. Group A (n=20) received antegrade crystalloid cardioplegia, Group B (n=20) received antegrade blood cardioplegia, and Group C (n=20) received antegrade blood cardioplegia with carnitine. Samples for lactate dehydrogenase (LDH), creatinine phosphokinase (CPK), creatinine phosphokinasemyocardial band (CK-MB), and Troponin-I were taken from coronary sinus during the operation and from peripheral venous line postoperatively. Blood samples were obtained before CPB, just after CPB and postoperative 1, 6, 12, 24 and 48 hours. Levels of CPK, CK-MB and Troponin-T levels were studied by immunoassay method.Results: The patients who received carnitine had significantly improved cardiac output, cardiac index, and right and left ventricular stroke work immediately after cardiopulmonary bypass and at the first postoperative hour (p=0.01). Troponin-T levels decreased in all patients after 12 hours postoperatively, andthis change was most prominent in Group C (p=0.001). Conclusion: Intravenous supplementation of carnitine duringcardioplegia provides better results on the recovery of cardiac function and metabolic parameters after coronary artery bypass grafting.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

L-karnitinin koroner arter baypas greftleme sonrası miyokard fonksiyonlarına etkisi

Öz:

Amaç: Bu çalışmada koroner arter baypas greftleme yapılan hastalarda L-karnitinin ameliyat sonrası kardiyak performans, morbidite ve komplikasyonlar üzerindeki etkisi değerlendirildi. Çalışma planı: Nisan 2005 - Haziran 2008 tarihleri arasında koroner arter baypas greftleme planlanan toplam 60 hasta (36 erkek, 24 kadın; ort. yaş 60.6 yıl; dağılım 57-65 yıl) prospektif olarak üç farklı miyokard koruma stratejisinden birine randomize edildi. Grup A’ya (n=20) antegrad kristaloid kardiyopleji, Grup B'ye (n=20) antegrad kan kardiyoplejisi ve Grup C’ye (n=20) karnitin ile birlikte antegrad kan kardiyoplejisi uygulandı. Laktat dehidrogenaz (LDH), kreatinin fosfokinaz (CPK), kreatinin fosfokinaz-miyokardiyal bant (CK-MB) ve Troponin-I için ameliyat sırasında koroner sinüsten ve postoperatif periferik venöz hattan KPB öncesi, KPB’da ve postoperatif 1, 6, 12, 24 ve 48 saat sonra kan numuneleri alındı. CPK, CK-MB ve Troponin-T seviyelerinin seviyeleri immünoassay yöntemi ile incelendi. Bulgular: Karnitin verilen hastaların kalp debisi, kardiyak indeksi, sağ ventrikül ve sol ventrikül atım işi kardiyopulmoner baypastan hemen sonra ve ameliyat sonrası birinci saatte anlamlı olarak düzeldi (p=0.01). Troponin-T düzeyleri ameliyattan 12 saat sonra tüm hastalarda azalırken, bu değişim en belirgin Grup C’de idi (p=0.001). Sonuç: Kardiyopleji sırasında intravenöz karnitin takviyesi, koroner arter baypas greftleme sonrası kardiyak fonksiyon ve metabolik parametrelerin iyileşmesinde daha iyi sonuçlar vermektedir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	FURAT C, İLHAN G, BAYAR E, Bozok Ş, GÜVENER M, Yılmaz M (2018). L-carnitine on myocardial function after coronary artery bypass grafting. , 22 - 29.
Chicago	FURAT Cevdet,İLHAN Gökhan,BAYAR Ekrem,Bozok Şahin,GÜVENER Murat,Yılmaz Mustafa L-carnitine on myocardial function after coronary artery bypass grafting. (2018): 22 - 29.
MLA	FURAT Cevdet,İLHAN Gökhan,BAYAR Ekrem,Bozok Şahin,GÜVENER Murat,Yılmaz Mustafa L-carnitine on myocardial function after coronary artery bypass grafting. , 2018, ss.22 - 29.
AMA	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M L-carnitine on myocardial function after coronary artery bypass grafting. . 2018; 22 - 29.
Vancouver	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M L-carnitine on myocardial function after coronary artery bypass grafting. . 2018; 22 - 29.
IEEE	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M "L-carnitine on myocardial function after coronary artery bypass grafting." , ss.22 - 29, 2018.
ISNAD	FURAT, Cevdet vd. "L-carnitine on myocardial function after coronary artery bypass grafting". (2018), 22-29.

APA	FURAT C, İLHAN G, BAYAR E, Bozok Ş, GÜVENER M, Yılmaz M (2018). L-carnitine on myocardial function after coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 26(1), 22 - 29.
Chicago	FURAT Cevdet,İLHAN Gökhan,BAYAR Ekrem,Bozok Şahin,GÜVENER Murat,Yılmaz Mustafa L-carnitine on myocardial function after coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi 26, no.1 (2018): 22 - 29.
MLA	FURAT Cevdet,İLHAN Gökhan,BAYAR Ekrem,Bozok Şahin,GÜVENER Murat,Yılmaz Mustafa L-carnitine on myocardial function after coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.26, no.1, 2018, ss.22 - 29.
AMA	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M L-carnitine on myocardial function after coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2018; 26(1): 22 - 29.
Vancouver	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M L-carnitine on myocardial function after coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2018; 26(1): 22 - 29.
IEEE	FURAT C,İLHAN G,BAYAR E,Bozok Ş,GÜVENER M,Yılmaz M "L-carnitine on myocardial function after coronary artery bypass grafting." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 26, ss.22 - 29, 2018.
ISNAD	FURAT, Cevdet vd. "L-carnitine on myocardial function after coronary artery bypass grafting". Türk Göğüs Kalp Damar Cerrahisi Dergisi 26/1 (2018), 22-29.