Echocardiographic Evaluation of the Effects of a Single Bolus of Erythropoietin on Reducing Ischemia-Reperfusion Injuries during Coronary Artery Bypass Graft Surgery; A Randomized, Double-Blind, Placebo-Control Study
- PMID: 24644377
- PMCID: PMC3957019
Echocardiographic Evaluation of the Effects of a Single Bolus of Erythropoietin on Reducing Ischemia-Reperfusion Injuries during Coronary Artery Bypass Graft Surgery; A Randomized, Double-Blind, Placebo-Control Study
Abstract
Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG).
Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG.
Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 vs. 45.90±4.97; P=0.334) and 30 days after surgery (47.27±28 vs. 46.62±5.7; P=0.69). There were no differences between the EPO and control groups in the wall motion score index at 4 (P=0.83) and 30 days after surgery (P=0.902). In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters (LVESD and LVEDD, respectively), as compared to the control group.
Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG.
Trial registration number: 138809102799N1.
Keywords: Coronary artery bypass graft; Erythropoietin; Ischemia; Reperfusion injury.
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References
-
- Adamson JW, Longo DL. Anemia and polycythemia. Hematologic alterations. In: Fauci A, Braunwald E, Kasper D, editors. Harrison’s principle of internal medicine. 17th ed. Vol. 2. New York: McGraw Hill; 2008. pp. 329–37.
-
- Brines ML, Ghezzi P, Keenan S, Agnello D, de Lanerolle, Cerami C, et al. Erythropoietin crosses the blood-brain barrier to protect against experimental brain injury. Proc Natl Acad Sci U S A. 2000;97:10526–31. doi: 10.1073/pnas.97.19.10526. PubMed PMID: 10984541; PubMed Central PMCID: PMC27058. - PMC - PubMed
-
- Vesey DA, Cheung C, Pat B, Endre Z, Gobe G, Johnson DW. Erythropoietin protects against ischaemic acute renal injury. Nephrol Dial Transplant. 2004;19: 348–55. doi: 10.1093/ndt/gfg547. PubMed PMID: 14736958. - PubMed
-
- Junk AK, Mammis A, Savitz SI, Singh M, Roth S, Malhotra S, et al. Erythropoietin administration protects retinal neurons from acute ischemia-reperfusion injury. Proc Natl Acad Sci U S A. 2002;99:10659–64. doi: 10.1073/pnas.152321399. PubMed PMID: 12130665; PubMed Central PMCID: PMC125005. - PMC - PubMed
-
- Ogilvie M, Yu X, Nicolas-Metral V, Pulido SM, Liu C, Ruegg UT, et al. Erythropoietin stimulates proliferation and interferes with differentiation of myoblasts. J Biol Chem. 2000;275:39754–61. doi: 10.1074/jbc.M004999200. PubMed PMID: 10995753. - PubMed
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