HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Terrence M. Yau Richard D. Weisel Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yau, T. M. Articles by Carson, S. Search for Related Content PubMed PubMed Citation Articles by Yau, T. M. Articles by Carson, S.

J Thorac Cardiovasc Surg 1994;108:302-310
© 1994 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

Vitamin E for coronary bypass operationsA prospective, double-blind, randomized trial

Toronto and Ottawa, Ontario, Canada

Supported by the Medical Research Council of Canada (grant MT 9829) and the Heart and Stroke Foundation of Ontario (grant B2267). Terrence M. Yau, MD, CM, was a Research Fellow of the Heart and Stroke Foundation of Canada. Richard D. Weisel, MD, is a Career Investigator of the Heart and Stroke Foundation of Ontario.

Received for publication Aug. 24, 1993. Accepted for publication Jan. 28, 1994. Address for reprints: Richard D. Weisel, MD, Toronto General Hospital, EN 14-215, 200 Elizabeth St., Toronto, Ontario M5G 2C4, Canada.

Abstract

Background: Free radical lipid peroxidation contributes to the abnormal metabolism and ventricular function frequently seen after cardiac operations. Antioxidants may improve metabolic and functional recovery. Methods: A prospective, randomized, double-blind clinical trial was conducted to determine the effects of vitamin E (alpha-tocopherol) (n= 14) or a corn oil placebo (n= 14) in patients undergoing elective coronary bypass operations. The RRR-alpha-tocopheryl acetate doubled the alpha-tocopherol levels in the heart. Myocardial metabolism and ventricular function were assessed after the operation. Results: Atrial pacing induced myocardial lactate production in the control patients but lactate consumption in the alpha-tocopherol–treated patients on bypass 25 minutes after crossclamp release. Left ventricular stroke work indices were higher, at similar ventricular volumes, in the alpha-tocopherol–treated group, which indicates improved preload recruitable stroke work, and diastolic compliance was greater 4 hours after the operation. The postoperative creatine kinase cardiac isoenzyme levels were lower in the patients who received alpha-tocopherol. Conclusions: Pretreatment with alpha-tocopherol sufficient to double the myocardial concentrations had a small but significant metabolic and functional effect after elective coronary bypass operations when compared with placebo. These results do not justify pretreatment of low-risk patients, but they do justify an evaluation in high-risk patients. (J THORACCARDIOVASCSURG1994;108:302-10)

This article has been cited by other articles:

				B. Ramlawi, H. Otu, S. Mieno, M. Boodhwani, N. R. Sodha, R. T. Clements, C. Bianchi, and F. W. Sellke Oxidative Stress and Atrial Fibrillation After Cardiac Surgery: A Case-Control Study Ann. Thorac. Surg., October 1, 2007; 84(4): 1166 - 1173. [Abstract] [Full Text] [PDF]

				J. Milei, P. Forcada, C. G. Fraga, D. R. Grana, G. Iannelli, M. Chiariello, I. Tritto, and G. Ambrosio Relationship between oxidative stress, lipid peroxidation, and ultrastructural damage in patients with coronary artery disease undergoing cardioplegic arrest/reperfusion Cardiovasc Res, March 1, 2007; 73(4): 710 - 719. [Abstract] [Full Text] [PDF]

				I. Koramaz, Z. Pulathan, S. Usta, S. C. Karahan, A. Alver, E. Yaris, N. I. Kalyoncu, and F. Ozcan Cardioprotective Effect of Cold-Blood Cardioplegia Enriched with N-Acetylcysteine During Coronary Artery Bypass Grafting Ann. Thorac. Surg., February 1, 2006; 81(2): 613 - 618. [Abstract] [Full Text] [PDF]

				L. G. Kevin, E. Novalija, and D. F. Stowe Reactive Oxygen Species as Mediators of Cardiac Injury and Protection: The Relevance to Anesthesia Practice Anesth. Analg., November 1, 2005; 101(5): 1275 - 1287. [Abstract] [Full Text] [PDF]

				C. R. Luyten, F. J. van Overveld, L. A. De Backer, A. M. Sadowska, I. E. Rodrigus, S. G. De Hert, and W. A. De Backer Antioxidant defence during cardiopulmonary bypass surgery Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 611 - 616. [Abstract] [Full Text] [PDF]

				A. Anselmi, A. Abbate, F. Girola, G. Nasso, G. G.L. Biondi-Zoccai, G. Possati, and M. Gaudino Myocardial ischemia, stunning, inflammation, and apoptosis during cardiac surgery: a review of evidence Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 304 - 311. [Abstract] [Full Text] [PDF]

				D. L. Ngaage Off-pump coronary artery bypass grafting: the myth, the logic and the science Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570. [Abstract] [Full Text] [PDF]

				A. Lassnigg, A. Punz, R. Barker, P. Keznickl, N. Manhart, E. Roth, and M. Hiesmayr Influence of intravenous vitamin E supplementation in cardiac surgery on oxidative stress: a double-blinded, randomized, controlled study Br. J. Anaesth., February 1, 2003; 90(2): 148 - 154. [Abstract] [Full Text] [PDF]

				G. Valli and E.-G. V. Giardina Benefits, adverse effects and drug interactionsof herbal therapies with cardiovascular effects J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1083 - 1095. [Abstract] [Full Text] [PDF]

				D. Paparella, T.M. Yau, and E. Young Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 232 - 244. [Abstract] [Full Text] [PDF]

				Z.-k. Wu, M. R. Tarkka, J. Eloranta, E. Pehkonen, L. Kaukinen, E. L. Honkonen, and S. Kaukinen Effect of Ischemic Preconditioning on Myocardial Protection in Coronary Artery Bypass Graft Patients : Can the Free Radicals Act as a Trigger for Ischemic Preconditioning? Chest, April 1, 2001; 119(4): 1061 - 1068. [Abstract] [Full Text] [PDF]

				G. L. Early and S. R. Roberts Excellence and low case volume: an example of the inapplicability of volume-based credentialing Ann. Thorac. Surg., January 1, 2000; 69(1): 146 - 150. [Abstract] [Full Text] [PDF]

				C. C. Tangney, J. S. Hankins, M. A. Murtaugh, and W. Piccione Jr Plasma Vitamins E and C Concentrations of Adult Patients During Cardiopulmonary Bypass J. Am. Coll. Nutr., April 1, 1998; 17(2): 162 - 170. [Abstract] [Full Text] [PDF]

				J. Westhuyzen, A. D. Cochrane, P. J. Tesar, T. Mau, D. B. Cross, M. P. Frenneaux, F. A. Khafagi, and S. J. Fleming EFFECT OF PREOPERATIVE SUPPLEMENTATION WITH {{alpha}}-TOCOPHEROL AND ASCORBIC ACID ON MYOCARDIAL INJURY IN PATIENTS UNDERGOING CARDIAC OPERATIONS J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 942 - 948. [Abstract] [Full Text]

				J. S. Ikonomidis, V. Rao, R. D. Weisel, N. Hayashida, and T. Shirai Myocardial Protection for Coronary Bypass Grafting: The Toronto Hospital Perspective Ann. Thorac. Surg., September 1, 1995; 60(3): 824 - 832. [Abstract] [Full Text]