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Open Access Research article

Protective effect of heparin in the end organ ischemia/reperfusion injury of the lungs and heart

Hikmet Selcuk Gedik1*, Kemal Korkmaz2, Havva Erdem3, Evvah Karakilic4, Gokhan Lafci5 and Handan Ankarali6

Author Affiliations

1 Cardiovascular Surgery Department of Ankara Numune Education and Research Hospital, Talatpasa Bulvari, 06100, Ankara, Turkey

2 Cardiovascular Surgery Department of Ankara Numune Education and Research Hospital, Talatpasa Bulvari, 06100, Ankara, Turkey

3 Pathology Department of Duzce University School of Medicine, Konuralp, Duzce, Turkey

4 Emergency Department of Ankara Numune Education and Research Hospital, Talatpasa Bulvari, 06100, Ankara, Turkey

5 Cardiovascular Surgery Department of Turkiye Yuksek Ihtisas Hospital Sihhiye, 06100, Ankara, Turkey

6 Biostatistic Department of Duzce University School of Medicine, Konuralp, Duzce, Turkey

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Journal of Cardiothoracic Surgery 2012, 7:123  doi:10.1186/1749-8090-7-123

Published: 15 November 2012

Abstract

Background

Ischemia/reperfusion (I/R) injury is harmful to the cardiovascular system and is responsible for the inflammatory response and multiple organ dysfunctions. In this study we investigated the effect of activated clotting time level on the aortic cross-clamping triggers a systemic inflammatory response and it effects to lungs and heart.

Methods

End organ concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO) and heat shock protein 70 (HSP-70) were determined in four groups of Spraque Dawley rats: ischemic control (operation with cross clamping received IP of 0.9% saline at 2 ml/kg n=7) Sham (operation without cross clamping, n=7), heparin (ACT level about 200), High dose heparin (ACT level up to 600) The infrarenal aorta was clamped for 45 minutes by a mini cross clamp approximately 1cm below the renal artery and 1cm iliac bifurcation in all groups without sham group. Heparin was given intraperitoneal (IP) before the procedure. All rats were sacrificed 48 h later. In a second experiment, the effects of I/R on remote organs (lungs and heart) were harvested for analysis. We evaluated tissue levels of myeloperoxidase, interleukin-6, and heat shock protein (HSP-70) were analyzed as markers oxidative stress and inflammation. Histological analyses of the organs were performed.

Results

The lungs paranchymal MPO and HSP-70 levels significantly decreased (p<0.05), but IL-6 level was not significant (p>0.05) in heparinized and high dose heparinized groups when compared to ischemic control group. Histopathological evaluation as edema, cell degeneration, inflammation statistically significantly decreased in both group heparinized and high dose heparinized compared with ischemic control group (p<0.05). The heart paranchymal MPO levels significantly decreased in heparinized and high dose heparinized groups when compared to ischemic control group (p=0.023). IL-6, HSP-70 levels were not significant heparinized and high dose heparinized groups when compared to ischemic control group (p=0.0489, p=0.0143). Histopathological evaluation as degeneration statistically significantly decreased in both group heparinized and High dose heparinized compared with ischemic control group (p=0.005).

Conclusion

Heparin decreased remote organs injury on the lung and heart after ischemia/reperfusion of infra-renal section of the body in the rat model. So, we should be balance to act level for avoid to I/R injury per operative and early post operative period as providing ACT level nearly 200.