What is the clinical evidence from this study?

Study design: Other. Population: Postischemic myocardial dysfunction (myocardial stunning) (n=27). Intervention: Allopurinol vs. Saline. Primary outcome: Recovery of contractile function (expressed as percent of preocclusion values) at 4 hours (p=<0.001).

What does this research mean for the field?

Inhibition of xanthine oxidase with allopurinol significantly improves contractile function recovery following brief regional myocardial ischemia and reperfusion. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 1987AJP Heart and Circulatory Physiology

Evidence for a pathogenetic role of xanthine oxidase in the "stunned" myocardium

Q: What are the key findings of this study?

Allopurinol significantly improved the recovery of contractile function compared to saline at 4 hours post-reperfusion (68% vs -17% of preocclusion values, P<0.001) in a canine model.

Q: What does this research mean for the field?

Inhibition of xanthine oxidase with allopurinol significantly improves contractile function recovery following brief regional myocardial ischemia and reperfusion. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Allopurinol improves post-reperfusion contractile recovery to 68% of baseline vs saline in preclinical model.

P<0.001
n=27

Why the study?

The mechanism for oxygen free radical production causing postischemic myocardial dysfunction (stunning) remains unknown, with xanthine oxidase as a potential source.

Does intravenous allopurinol improve recovery of contractile function in open-chest dogs undergoing LAD occlusion and reperfusion?

Comparison

Intravenous allopurinol vs intravenous saline

Design

Preclinical experimental study

Follow-up

4 hours

Authors

MCM. I. Charlat POPadraig Gearoid O’NeillMercy General Hospital JEJM EganNational Institutes of Health

Discussion

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Implication

Should not change clinical reperfusion practice; leaves open whether xanthine oxidase inhibition improves human postischemic recovery.

Structured PICO

Does intravenous allopurinol improve recovery of contractile function in open-chest dogs undergoing LAD occlusion and reperfusion?

Population

27 open-chest dogs undergoing 15-minute LAD occlusion followed by 4 hours of reperfusion.

Intervention

Intravenous allopurinol (50 mg/kg 48 h, 20 h, and 30 min before occlusion, 10 mg/kg 1 min before reperfusion, and 6.25 mg/kg/h throughout reperfusion)

Comparator

Intravenous saline

Outcome

Recovery of contractile function (systolic wall thickening) following reperfusionsurrogate

Main Result

Absolute Event Rate: 68% vs -17%

p-value: p=<0.001

Allopurinol improves recovery of contractile function in a canine model of myocardial stunning, suggesting xanthine oxidase is a source of oxygen free radicals responsible for postischemic dysfunction.

Cite This Study

Charlat et al. (1987) studied Postischemic myocardial dysfunction (myocardial stunning) (n=27). Allopurinol vs. Saline was evaluated on Recovery of contractile function (expressed as percent of preocclusion values) at 4 hours (p=<0.001). Allopurinol significantly improved the recovery of contractile function compared to saline at 4 hours post-reperfusion (68% vs -17% of preocclusion values, P<0.001) in a canine model.

synapsesocial.com/papers/6ab7650b292bbdfff15901b1 https://doi.org/10.1152/ajpheart.1987.252.3.h566

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Evidence for a pathogenetic role of xanthine oxidase in the "stunned" myocardium

Discussion

Member takes

Implication

Structured PICO

Main Result

Cite This Study

Evidence for a pathogenetic role of xanthine oxidase in the "stunned" myocardium

Discussion

Member takes

Implication

Structured PICO

Main Result

Cite This Study

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Also Consider