Effects of Ischemic Postconditioning on MicroRNAs in Double Valve Replacement

Central South University8 enrolled

Overview

1. Cardiopulmonary bypass and cardioplegic arrest could regulate expression of microRNAs in patients undergoing double valve replacement (aortic and mitral). 2. The modulation of myocardial microRNAs by cardiopulmonary bypass and cardioplegic arrest may be rescued by ischemic postconditioning. 3. Downstream effectors would also be affected.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

QUADRUPLE

Enrollment

Conditions

Cardiopulmonary Bypass Ischemic Postconditioning

Interventions

ischemic postconditioningPROCEDURE

multiple brief ischemic-reperfusion episodes immediately after sustained ischemic insult Postconditioning was started at 30 s after aortic cross declamping, and the aorta was re-clamped for 30 s rendering global myocardial ischemia. Meanwhile aortic root suction was established during aortic re-clamping, and thereafter, the aortic clamp was released for 30 s for full myocardial reperfusion. The cycle was repeated three times after cardioplegic arrest.

double valve replacementPROCEDURE

The double valve replacement is a procedure in which surgery is used to replace diseased aortic and mitral heart valves.

heart-lung machineDEVICE

The heart-lung machine is commonly used in open heart surgery including double valve replacement to support the circulation during the operation.

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Consecutive eight patients with rheumatic heart valve disease undergoing elective double valve replacement(aortic and mitral)are considered for participation in this study. Exclusion Criteria: * insulin-dependent diabetes mellitus * pulmonary, renal, or hepatic failure * infective valve disease * valve disease with coronary artery disease * hypertension * emergency and reoperations * received aspirin,corticosteroids, or statin preoperatively * received preoperative inotropic support

Locations (1)

Xiangya Hospital

Changsha, Hunan, China

Outcomes

Primary Outcomes

Change from Baseline in Cardiac MicroRNA Expression

Samples were harvested from all the patients, respectively, before cardiopulmonary bypass and at 5 min after aortic de-clamping. Real-time quantitative stem-loop reverse transcription polymerase chain reaction assay was performed to detect the expression of microRNAs.

Time frame: before cardiopulmonary bypass and at 5 min after aortic de-clamping

Secondary Outcomes

Change from Baseline in Downstream Gene Expression

Expressions of messenger RNAs and proteins were quantified for genes which are regulated by above-detected microRNAs.

Time frame: before cardiopulmonary bypass and at 5 min after aortic de-clamping

Data from ClinicalTrials.gov

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