1. The protective effects of L‐carnitine on myocardial ischaemia–reperfusion injury in patients with rheumatic valvular heart disease undergoing <scp>CPB</scp> surgery are associated with the suppression of <scp>NF</scp> ‐κB pathway and the activation of Nrf2 pathway
- Author
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Ming Li, Yang Yan, Qiuyue Yi, Chao Deng, Wen Li, Yan Geng, Suochun Xu, Ruili Wang, Yongxin Li, Lei Sun, Haichen Wang, Li Xue, Yongjian Zhang, and Junjun Hao
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Physiology ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,medicine.artery ,Troponin I ,medicine ,Carnitine ,Pharmacology ,Aorta ,Ejection fraction ,biology ,business.industry ,valvular heart disease ,medicine.disease ,Surgery ,030104 developmental biology ,030220 oncology & carcinogenesis ,Myeloperoxidase ,biology.protein ,business ,Reperfusion injury ,Oxidative stress ,medicine.drug - Abstract
Myocardial ischaemia-reperfusion injury (MIRI) is a main pathophysiologic change following CPB surgery. L-carnitine, a natural amino acid, is able to transport fatty acids for generating energy and has a protective effect on MIRI. We aim to investigate the protective effect of L-carnitine on MIRI in patients with rheumatic valvular heart disease (RVHD) performed CPB surgical operation and the underlying mechanism. In this study, patients were randomized to three groups. L-carnitine was added to the crystalloid cardioplegic solution for experimental group 1 (6 g/L) and experimental group 2 (12 g/L), whereas no L-carnitine was used in the control group. Our results showed that L-carnitine significantly attenuated myocardial injury after surgery in these patients. L-carnitine decreased serum markers of myocardial injury including CK-MB, cTnI, hs-cTnT and IMA. L-carnitine increased left ventricular ejection fraction (LVEF) but reduced wall motion score index (WMSI) after operation. L-carnitine also inhibited myeloperoxidase (MPO) activity and inflammatory cytokines in the myocardium of patients after unclamping the aorta. Additionally, L-carnitine increased levels of superoxide dismutase (SOD) and catalase (CAT) while decreased levels of malondialdehyde (MDA) and protein carbonyl content in the myocardium of patients after unclamping the aorta. Moreover, L-carnitine suppressed the activation of nuclear factor kappa B (NF-κB) and activated nuclear factor erythroid 2-related factor 2 (Nrf2). There was also no significant difference in these indices between two experimental groups after unclamping the aorta. Taken together, L-carnitine had a protective effect against CPB-induced MIRI in patients with RVHD, which might be related to its modulation of NF-κB and Nrf2 activities.
- Published
- 2019