Mickle D A, Weisel R D, Burton G W, Ingold K U
Department of Clinical Biochemistry, Toronto General Hospital, University of Toronto, Ontario, Canada.
Cardiovasc Drugs Ther. 1991 Mar;5 Suppl 2:309-12. doi: 10.1007/BF00054753.
Free radical injury may contribute to the delayed postoperative recovery of myocardial metabolism and ventricular function after elective coronary artery revascularization. This clinical study was designed to evaluate, in stable angina patients having aortocoronary bypass surgery, whether orally administered alpha-tocopheryl acetate was effective in increasing myocardial alpha-tocopherol levels and the effect of cardioplegic arrest followed by reperfusion on the myocardial alpha-tocopherol levels. Twenty-four patients with stable angina pectoris for elective revascularization received preoperatively the natural stereoisomer of alpha-tocopheryl acetate labelled with deuterium (D3) and six patients were used as controls. Since four patients who received 300 mg of D3-alpha-tocopheryl acetate preoperatively for 1 and 2 days did not have significant increases in their myocardial total or D3-tocopherol levels, the remaining 20 patients received 100 mg (n = 6), 300 mg (n = 8), or 900 mg (n = 6) of D3-alpha-tocopheryl acetate for 14 consecutive preoperative days. The left ventricular deuterated and nondeuterated alpha-tocopherol levels were measured by gas chromatography/mass spectrometry. Although there was a decrease (p less than 0.05) in myocardial alpha-tocopherol levels with the onset of reperfusion (cross-clamp removal), the myocardial tocopherol levels were not statistically different from preoperative levels by 20 minutes of reperfusion. At least 300 mg of alpha-tocopherol must be taken orally for 14 consecutive days to double the myocardial alpha-tocopherol levels.
自由基损伤可能导致择期冠状动脉血运重建术后心肌代谢和心室功能的延迟恢复。本临床研究旨在评估，在接受主动脉冠状动脉搭桥手术的稳定型心绞痛患者中，口服醋酸生育酚是否能有效提高心肌生育酚水平，以及心脏停搏后再灌注对心肌生育酚水平的影响。24例择期血运重建的稳定型心绞痛患者术前接受了用氘（D3）标记的醋酸生育酚的天然立体异构体，6例患者作为对照。由于4例术前1天和2天接受300mg D3 - 醋酸生育酚的患者心肌总生育酚或D3 - 生育酚水平没有显著升高，其余20例患者术前连续14天接受100mg（n = 6）、300mg（n = 8）或900mg（n = 6）的D3 - 醋酸生育酚。通过气相色谱/质谱法测量左心室氘代和非氘代生育酚水平。尽管再灌注开始时（松开交叉夹）心肌生育酚水平有所下降（p < 0.05），但再灌注20分钟时心肌生育酚水平与术前水平无统计学差异。必须连续14天口服至少300mg生育酚才能使心肌生育酚水平翻倍。
