| Objective To investigate the myocardioprotective effect of nicorandil preconditioning in ischemia-reperfusion myocardium in adult patients undergoing open-heart surgery.Methods Forty patients undergoing open-heart surgical operation were randomly divided into control group (n=20) and Nicorandil ischemic preconditioning group (Nicorandic IPC group) (n=20). Control group and Nicorandic IPC group patients were injected with equal volume of normal saline and Nicorandil respectively though center venous via after Intravenous Inhalational Anesthesia. Plasma levels of cardiac troponin I(CTnI), creatine kinase- MB(CKMB) and lactate dehydro-genase(LDH) were documented after anesthesia induction, 5min after aortic clamping, 10min after aortic declamp, 1hour after staying in ICU and 1 day and 2 days after operation respectively. Biopsies of right atriom were taken and analyzed under electron microscope. Arrest time, spontaneous re-suscitation rate, the requirement for inotropics, intubation time and ICU stay time were also evaluated.Results Control group had higher CTnI and CKMB level compared to Nicorandic IPC group (P<0.05) at 5 min after aortic clamping, 10min after aortic declamping, 1 hour after staying in ICU. Control group also had higher LDH level compared to Nicorandil ischemic preconditioning group (P<0.05) at 10 min after aortic declamping. Arrest time of control group was longer than that of Nicorandil IPC group (P<0.05). Microscopic Observation showed that Nicoandil IPC group had better myocardial ultrastructure and less damaged myocardial mitochondrial(P<0.05).Conclusion These results suggest Nicorandil ischemic preconditioning can decrease the ischemia-reperrusion injury and possess significant myocardial protective effect. |
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