Does aprotinin modify the effects of ischaemia-reperfusion on the myocardial performance of a blood perfused isolated rabbit heart?

Abstract

Aprotinin has been reported to influence positively or negatively the process of ischaemia-reperfusion. However, it is a complex drug acting on platelets, neutrophils and coagulation, which may also have a direct effect by inhibiting intracellular proteases and free radical generation. The goal of this study was to determine the direct effects of aprotinin on the myocardial performances of an isolated blood perfused rabbit heart preparation after normothermic global ischaemia. Two groups of 10 hearts were studied. The control group (ischaemia) underwent 30 min of global normothermic ischaemia. In the aprotinin group, (aprotinin) 200 KUI mL-1 of aprotinin was added to the perfusate before ischaemia. Measurements were obtained at base-line, 10, 30 and 60 min after reperfusion. Normothermic ischaemia significantly decreased myocardial performance in both groups. After 60 min reperfusion, myocardial contractility significantly recovered in the aprotinin group compared with the ischaemia group. Aprotinin contributes significantly by limiting the consequences of ischaemia on myocardial performances. This effect may be due to a direct action of the drug because leucocytes and plasma proteins were removed in this preparation.

Effects of Half‐dose Aprotinin in Off‐pump Coronary Artery Bypass Grafting

“…It has been suggested that the cardioprotective effect of aprotinin may derive from antiinflammatory properties and/or direct effect of aprotinin on the myocardium. 1,6,23 Patients undergoing OPCAB with poor myocardial function may get more benefit from aprotinin besides the hemostatic effect. Procoagulant activity after OPCAB has been reported with biochemical terms.…”

“…The mechanism underlying the cardioprotective effect of aprotinin is unclear. It has been suggested that the cardioprotective effect of aprotinin may derive from anti‐inflammatory properties and/or direct effect of aprotinin on the myocardium 1,6,23. Patients undergoing OPCAB with poor myocardial function may get more benefit from aprotinin besides the hemostatic effect.…”