Coenzyme Q10: the prophylactic effect on low cardiac output following cardiac valve replacement

A randomized, prospective study of the effectiveness of preoperative administration of coenzyme Q10 on the prophylaxis of postoperative low cardiac output state was performed in 50 patients with acquired valvular diseases necessitating valve replacement. There were 25 patients in the treatment group and 25 in the control group. Patients in the treatment group received 30 to 60 mg of coenzyme Q10 orally for six days before operation. Preoperative clinical variables, operative procedures, total cardiopulmonary bypass time, and aortic cross-clamping time were similar for the two groups. Postoperatively, mild to severe low cardiac output state developed in 28 of 50 patients (56%) and necessitated the administration of considerable amounts of inotropic agent. The treatment group showed a significantly lower incidence of low cardiac output state during the recovery period than the control group (p less than 0.05). These results suggest that preoperative administration of coenzyme Q10 will increase the tolerance of human hearts to ischemia during aortic cross-clamping.

Lung function in adults with mycoplasmal pneumonia

We prospectively studied on lung function of 17 patients (7 men and 10 women) of acute Mycoplasma pneumoniae pneumonia. Lung function tests including %VC, FEV1.0%, Peak flow, V75/HT, V25/HT, V50/V25 and MMF were measured during the acute and convalescent stage. The results showed dysfunction of peripheral airway because of reduction in V50/HT, V25/HT and MMF. It was suggested that lung function in patients with Mycoplasma pneumoniae pneumonia was impaired at the high lung volume as well as low lung volume.

Efficacy of systolic vs diastolic pulsation beyond severe coronary stenosis flow

This paper describes the superiority of systolic pulsatile selective coronary perfusion as compared to diastolic pulsatile coronary perfusion in improving flow beyond ischemia-producing coronary artery obstructions in the working heart. The practical implications for use in coronary support perfusion systems are discussed.

The deleterious effects of surgically induced complete right bundle branch block on long-term follow-up results of closure of ventricular septal defect

The effects of complete right bundle branch block (CRBBB) on the early postoperative course and long-term follow-up results of closure of ventricle septal defect (VSD) were investigated. (1) Postoperative change in cardiothoracic ratio (CTR); In patients whose ratio of total pulmonary resistance to total systemic resistance (Rp/Rs) was larger than or equal to 0.33, CTR of the group with CRBBB did not decrease significantly (p greater than 0.1) but CTR of the group without CRBBB was improved markedly (p less than 0.01). However, in patients whose Rp/Rs was less than 0.33, there was no significant difference in CTR reduction between the two groups. (2) Postoperative change in Rp/Rs in patients with preoperative Rp/Rs larger than or equal to 0.33: In the group with CRBBB the Rp/Rs decreased from a preoperative average of 36 to 27 percent; in the group without CRBBB, it decreased from 39 to 21 percent. There were significant differences in both the postoperative value of RP/Rs and the degree of postoperative decrease in Rp/Rs between the two groups (both p less than 0.05). (3) Change of pulse rate in the early postoperative period: In patients with Rp/Rs larger than or equal to 0.33, the postoperative increase in pulse rate of the group with CRBBB was significantly higher than that of the group without CRBBB (p less than 0.05). These results suggest that CRBBB has a strong deleterious effect on right ventricular function. The possibility that CRBBB has an ill effect on left ventricular function in patients with Rp/Rs larger than or equal to 0.33 is discussed.