| Research Abstract |
<Basic research> Using the rat working heart preperation, the role and relation of gaseous molecules (nitric oxide, NO ; carbon monoxide, CO) during tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-Iβ) induced cardiac depression. Administration of cytokines depressed the left ventricular work (LVW). Administrations of NO synthase (NOS) inhibitor, L-canavanin (CAN) and CO synthase (hemeoxygenase) inhibitor, zinc protoporphyrine (ZPP) improved the LVW. Gene expressions of inducible NOS (iNOS) and inducible HO (HO-1) in the left ventricle significantly increased 2 hours after perfusion. Administration of CAN inhibited the increase of HO-1 expression, and adminstration, of ZPP inhibited the HO-1 expression and promoted the INOS expression. These data suggest that NOS/NO systema and HO/CO system are interrelated at the gene ezpression levels even when those systems are highly promoted, however, the interaction of both systems on cardiac contractility did not make clear and other factors are speculated to be important under those situation. <Clinical research> Changes in CO generation during coronary artery bypass graft by measuring CO-Hb concentrations and the expression of HO in circulating blood as well as the expressions of TNF-α and IL-1β. CO-Hb significantly increased after surgery ; however, those values did not significantly change in patients who showed CO-Hb 【greater than or equal】1.0% before surgery. The expression ratios of HO-1, TNF-α, and IL-1β significantly increased after surgery. CO-Hb significantly correlated with the expression ratios of the inflammatory mediators ; however, the correlation was low in the patients who showed CO-Hb 【greater than or equal】1.0% before surgery. These data indicate that CO-Hb can, in general, reflect the surgical inflammatory response ; however, the usefulness of CO-Hb as a marker of surgical stress might be limited to certain patients.
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