Smenes 2018 Interact Cardiovasc Thorac Surg
Smenes BT, BΓ¦kkerud FH, Slagsvold KH, Hassel E, Wohlwend M, Pinho M, HΓΈydal M, WislΓΈff U, Rognmo Γ, Wahba A (2018) Acute exercise is not cardioprotective and may induce apoptotic signalling in heart surgery: a randomized controlled trial. Interact Cardiovasc Thorac Surg 27:95-101. |
Smenes BT, Baekkerud FH, Slagsvold KH, Hassel E, Wohlwend M, Pinho M, Hoeydal M, Wisloeff U, Rognmo Oe, Wahba A (2018) Interact Cardiovasc Thorac Surg
Abstract: During open-heart surgery, the myocardium experiences ischaemia-reperfusion injury. A single bout of moderate, 30-min exercise induces preconditioning and protects the heart from ischaemia-reperfusion injury in rats, but this has never been investigated in humans. We aimed to investigate whether 1 bout of moderate exercise 24βh prior to surgery protects against mitochondrial and cardiac damage.
Patients scheduled for elective coronary artery bypass were eligible for this pilot study. Twenty were included and randomized to the treadmill exercise group (the EX group, nβ=β10) 24βh preoperatively or to standard presurgical procedures (control nβ=β10). Right atrial (RA) and left ventricular (LV) biopsies were collected immediately before and as long as possible after aortic cross-clamping to assess the primary outcome of mitochondrial respiration by respirometry, in addition to reactive oxygen species production by fluorometry and apoptotic transcripts. Cardiac troponin T and creatine kinase myocardial brain were measured in plasma at arrival, before surgery and 6 and 24βh postoperatively.
Mitochondrial respiration was lower in the EX group after surgery in the LV (Complex I -22%, Pβ<β0.05 and maximal -23%, Pβ<β0.05) and the right atrium (Complex I -25%, Pβ<β0.05). Transcript level of the apoptosis-related marker caspase 3 was increased 1.5-fold in the LV prior to surgery in the EX group when compared with the control group, Pβ<β0.05. Cardiac troponin T was 45% higher in the EX group than in the control group 6βh postoperatively (Pβ=β0.03), although not significant when corrected for aortic cross-clamping time.
Results indicate that exercise did not precondition the heart against surgery-related damage. Exercise may render the myocardium and mitochondria more vulnerable to perioperative damage.
Β© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. β’ Keywords: Caspase-3, Ischaemiaβreperfusion, Mitochondria, Preconditioning, Troponin, Amplex Red in muscle fibers β’ Bioblast editor: Kandolf G, Smenes BT β’ O2k-Network Lab: NO Trondheim Rognmo O
Labels: MiParea: Respiration, Exercise physiology;nutrition;life style, Patients
Pathology: Aging;senescence, Cardiovascular
Stress:Ischemia-reperfusion
Organism: Human
Tissue;cell: Heart
Preparation: Permeabilized tissue
Coupling state: LEAK, OXPHOS, ET
Pathway: F, N, S, CIV, NS, ROX
HRR: Oxygraph-2k, O2k-Fluorometer
2018-03, AmR