The Myocardial Protective Effect Of Carvedilol Against Ischemia-reperfusion Injury In Patients With Rheumatic Heart Disease Undergoing Open Heart Surgery

[ Objective ] To investigate the myocardial protective effect of carvedilol against ischemia-reperfusion injury in patients with rheumatic heart disease undergoing open heart surgery under cardiopulmonary bypass (CPB). [ Method ] Thirty patients with rheumatic heart disease undergoing heart valve replacement under CPB were randomly divided into two groups ,carvedilol group and control group.There were 15 patients in each group.The patients in the carvedilol group ,4 males and 11 females, mean age 53.60 ±8.17, New York Heart Association (NYHA) functional class Ⅱ~ Ⅲ,2 Ⅱ and 13 Ⅲ ,12 patients undergoing mitral valve replacement and 3 patients undergoing double-valve replacement(mitral and aortic valve replacement), took orally carvedilol 10mg q12h, digacin 0.25mg qd,hydrochlorothiazide 50mg qd,captopril 12.5mg bid in 7 to 10 days before operation.The patients in the control group,6 males and 9 females,mean age 56.73 ±9.35,NYHA functional class Ⅱ~Ⅲ,3 Ⅱ and 12 Ⅲ,12 mitral valve replacement and 3 double-valve replacement,only received digacin 0.25mg qd,hydrochlorothiazide 50mg qd,Captopril 12.5mg bid in 7 to 10 days before operation.Venous blood samples were taken before CPB, 2h,4h,8h,24h,72h after the beginning of CPB for determination of plasma levels of creatine kinase(CK),isoenzyme of creatine kinase-MB(CK-MB) and cardiac troponin-I(CTn-I). The rate of spontaneous recovery of heart beat after release of the aortic cross-clamp,the incidence of ventricular arrhythmia after recovery of heart beat, the application time of dopamine,and so on,were taken down. [Result] There was no significant difference in CPB time,aortic cross-clamping time and parallel circulation time between the two groups(P>0.05).The plasma activities of CK,CK-MB and CTn-I were all within normal range before CPB and increased significantly at 2h,4h,8h,24h after the beginning of CPB in both groups.Their activities in plasma peaked at 24h,4h,8h...