Dynamics of lipid peroxidation in cardiac valve defects in cardiac surgery patientsagainst the background of a combined antioxidant strategy

Abstract

Introduction. Oxidative stress develops during ischemia-reperfusion injury, which occurs in cardiac surgeries utilizing cardiopulmonary bypass and exerts a damaging effect on the myocardium. Currently, there are no optimal methods to counteract the oxidative processes activated during artificial circulation. Objective of the study. To analyze lipid peroxidation processes in blood plasma in response to molecular hydrogen (H₂), nitric oxide (NO), and their combined use in patients with valvular heart disease undergoing cardiac surgery.

Methods. This study investigated the dynamics of dien conjugates (DC), triene conjugates (TC), and Schiff bases (SB) in the blood plasma of patients with valvular heart defects. The effects of H₂, NO, and their combination were examined during cardiopulmonary bypass (CPB) lasting less than and more than 90 minutes.

Results. The findings demonstrated that the use of H₂, NO, and their combination led to a reduction in lipid peroxidation in the blood plasma of patients during CPB and at the end of surgery, compared to the control group, where oxidative processes intensified throughout the procedure. The application of H₂, alone and combined with NO, showed a significant decrease in DC, TC, and SB levels relative to NO monotherapy. The most pronounced effect was observed when H₂ and NO were used jointly during CPB durations exceeding 90 minutes.

Conclusion. The combined use of H₂ and NO is more effective than monotherapy with these gases in limiting oxidative stress during cardiopulmonary bypass in cardiac surgeries. This synergistic effect likely enhances antioxidant protection, reducing the progression of oxidative damage associated with artificial circulation.