Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Ayman Khairy M Hassan
Assiut University, Egypt
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Background: Losartan at therapeutic doses have beneficial cardiovascular protective effects. The aim of the study was to investigate possible cardio-protective effect of this drug alone or in combination with remote ischemic Preconditioning (RIPC) on the biochemical changes induced by ischemic/reperfusion injury (I/R) in a combined prospective study with a clinical and experimental animal arm. Methods: Thirty consecutive patients undergoing elective percutaneous coronary intervention (PCI) were recruited. Patients were divided into three groups (10 each): Group-1: Control group which includes patients who were exposed to PCI without any preconditioning. Group-2: Patients who were maintained on losartan at a dose 50-100 mg/day for at least one month before undergoing PCI. Group-3: Patients who were maintained on losartan at a dose 20 mg/day for at least one month before the day of PCI that was preceded by RIPC. On the other hand; sixty adult male New Zealand white rabbits weighing 1500-2500 grams have been used in the experimental arm of the study. The rabbits were divided into 6 groups (n=10): Group I (control), Group II (sham), Group III (I/R as 30 min ischemia followed by 120 min reperfusion), Group IV (regular losartan 20 mg/kg for 40 days orally followed by I/R), Group V (I/R preceded by RIPC) and Group VI (exactly similar to groups IV in exposure to drug but I/R was preceded by RIPC). Biochemical parameters reflecting cardiac damage due to I/R were measured in blood for all clinical and experimental groups for comparison. These parameters included tumor necrosis factor-�?± (TNF-�?±), interleukin-6 (IL-6), nitric oxide (NO), troponin I (cTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP). In groups III, IV, V and VI blood sample were withdrawn following I/R. Results: It was found that patients who received pretreatment with losartan before undergoing PCI and patients who received the drug and exposed to RIPC before doing PCI developed significant reduction (P<0.05) in serum levels of IL-6, TNF-�?±, CRP, cTnI and CK-MB associated with significant increase (P<0.05) in serum level of NO compared with corresponding values in patients who were exposed directly to PCI without losartan pretreatment and/or RIPC. In Group III, I/R induced significant elevation in all biochemical parameters except NO which was significantly reduced compared with control or sham groups. In Group IV, RIPC showed a protective effect against I/R injury as evidenced by significant reduction (P<0.05) in the levels of TNF-�?±, IL-6, CK-MB and CRP while the level of NO was significantly (P<0.05) increased compared with Group III. In Group V, losartan significantly (P<0.05) reduced the levels of TNF-�?±, IL-6 and CRP compared with Group III but no elevation in NO was recorded in the group. In Group VI, losartan combined with RIPC showed a possible synergistic protective effect as the levels of TNF-�?±, IL-6, CK-MB and CRP were significantly reduced (P<0.001) while NO significantly (P<0.001) increased compared with Group III. Conclusions: Pretreatment with losartan combined with RIPC can exert a synergistic cardioprotective effects by reducing the possible biochemical changes related to ischemic reperfusion injury.
Email: aymankhairy11@gmail.com