Research on correlation between the protection effect of cold autologous blood cardioplegia solution to immature myocardium and the P-AKT

Ma Chao; Zhang Qing; Shen Ding-rong; Wang Yuan-xiang; Peng Le; Meng Bao-ying; Ti Yun-xing; Ding Yi-qun

doi:10.13498/j.cnki.chin.j.ecc.2017.01.02

Abstract：Objective To explore the correlation between the protection effect of cold autologous blood cardioplegia solution to immature myocardium and the phosphorylated protein kinase B (P-AKT).Methods 82 infants with cyanotic congenital heart disease undergoing cardiac surgery were randomly divided into cold non-autologous blood cardioplegic solution (A) group (n=33) and cold autologous blood cardioplegic solution group (B) group (n=49).The right auricle tissue was taken before the aortic cross-clamping and 30 minute after the aortic cross-clamping to detect myocardial cell apoptosis and calculate the apoptosis index (AI) with TUNEL method,and to detect the phosphorylated AKT (P-AKT) with the immunohistochemical method.The auto-beating time and rate during operation,the left ventricular myocardial performance index (Tei Index),the cardiac Index (CI),left ventricular ejection fraction (LVEF),positive inotropic drug administration 2 hs postoperatively,and the incidence rate of cardiac arrhythmia 24 hs postoperatively of all patients were recorded.Results There was no significant difference on the levels of P-AKT and AI before the aortic cross-clamping between 2 groups (P>0.05),while all significantly elevated 30 minutes after the aortic cross-clamping (p<0.05).There were significant differences on the auto-beating time,left ventricular Tei index,CI,LVEF and positive inotropic drug administration 2 hs postoperatively,the incidence rate of cardiac arrhythmia 24 hs postoperatively between two groups (P<0.05).The level of P-AKT in myocardial tissue was negatively correlated with AI,auto-beating time and Tei index (P<0.05),positively correlated with the LVEF and CI (P<0.05).Conclusion Compared with cold non-autologous blood cardioplegic solution,cold autologous blood cardioplegic solution can promote myocardial p-AKT protein expression,reduce myocardial cell apoptosis,and has better protective effects for immature myocardium.