Effect Of Adding Morphine Into Cardioplegiaon On Myocardial Cell Apoptosis Peri-Heart Valve Replacement

Objective To investigate the effect of adding morphine into cardioplegia on myocardial protection during cardiopulmonary bypass in the cases of heart valves replacemen.Methods 20 patients were randomly divided into two groups,Group A,cardioprotection proceeded with normal cardioplegia plus morphine in concentration of 2μmol/L;Group B,cardioprotection proceeded with normal cardioplegia as contrast.The apoptosis granule positive rate(AGPR),the heart tissue sections observed under electroscope,the rate of cardiac arrhythmia,cardiac insufficiency,the duration of ventilation and staying in ICU,average hospitalizationion days were investigated. The blood samples were obtained from peripheral venous catheter for testing creatine kinase—MB(CK—MB)and cardiac troponin I(cTnI)as well.Results The rate of apoptosis granule on both two groups postoperation are higher than the rate of the two groups during preoperation(P＜0.05),and the AGPR of group A postoperation is lower than the group B postoperation(P＜0.05),.Electron microscopy revealed that the group B changed more significantly than those of the group A.The levels of cTnI in Group B were higher than group A on the time of 2h,24h after surgery respectively(P＜0.05)The cardiac arrhythmia,cardiac insufficiency rate of group A are lower than group B,but there is no statistical diference between the two groups(P＞0.05).The changes of cTnI level correlated with AGPR(2h r=0.675 P＜0.05 12hr=0.738 p＜0.05 24h r=0.581 P＜0.05).Conclusion Adding morphine into cardioplegia can reduce the myocardial cell apoptosis during cardiopulmonary bypass in the cases of heart valves replacement.