Effect of L-carnitine on myocardial injury in children undergoing open heart surgery - Trial PACTR202010570607420

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Summary

Myocardial injury and myocardial dysfunction after cardiac surgery of congenital heart disease are closely related to morbidity and mortality. Cardiopulmonary bypass (CPB) is related to multiple effects that may contribute to postoperative myocardial injury and cardiac dysfunction including ischemia-reperfusion injury after removal of aortic clamp, the subsequent generation of reactive oxygen species and increased production of inflammatory mediators. Oxidative stress may promote myocardial injury either due to direct myocardial damage through lipid peroxidation and protein changes or through induction of apoptosis of cardiomyocytes that are exposed to ischemia-reperfusion . There are two apoptotic pathways; the extrinsic pathway which activated by death receptors and the intrinsic pathway which can be activated by hypoxia and oxidative stress that occur due to cardiopulmonary bypass.L-carnitine is an endogenous amino acid that has an important role in metabolism of fatty acid and carbohydrate. It was reported to have myocardial protective effects in rheumatic valvular surgery and coronary artery bypass graft (CABG) in adults.Aim of the work: The aim of this study is to investigate the possible myocardial protective effect of L-carnitine in children undergoing open heart surgery by investigating L-carnitine effects on oxidative stress, apoptosis and myocardial injury induced by cardiopulmonary bypass.

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