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BioMed Research International
Volume 2017, Article ID 6082430, 8 pages
Clinical Study

Efficacy and Mechanism of Preoperative Simvastatin Therapy on Myocardial Protection after Extracorporeal Circulation

1Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
2Department of Vascular Surgery, Henan Provincial People’s Hospital, Zhengzhou 450003, China
3The Biobank of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
4Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China

Correspondence should be addressed to Ping Hua; moc.anis@88gnipauh and Songran Yang; moc.621@nargnosgnay

Ping Hua and Jianyang Liu contributed equally to this work.

Received 4 June 2017; Revised 8 September 2017; Accepted 26 September 2017; Published 8 November 2017

Academic Editor: Gjumrakch Aliev

Copyright © 2017 Ping Hua et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Cardiopulmonary bypass (CPB) causes systemic inflammatory response and ischemia-reperfusion (IR) injury. Objective. To investigate the effect and mechanism of simvastatin on myocardial injury in cardiac valve surgery with CPB. Methods. One hundred thirty patients were randomly assigned to the statin group () or control group (). Simvastatin was administered preoperatively and postoperatively. Duration of intensive care unit stay, duration of assisted ventilation, and left ventricular ejection fraction were recorded. Plasma was analysed for troponin T (cTnT), isoenzyme of creatine kinase (CK-MB), tumor necrosis factor alpha (TNF-), interleukin-6 (IL-6), and interleukin-8 (IL-8). Ultrastructure of the myocardium and autophagosomes were observed. Beclin-1, LC3-II/I, P62, AMPK, and the phosphorylation of AMPK in cardiomyocytes were detected. Results. Simvastatin significantly reduced the duration of assisted ventilation () and ejection fraction was significantly higher in the statin group (). Simvastatin significantly reduced the levels of cTnT, CK-MB, TNF-, IL-6, and IL-8 (), reduced the expression of LC3-II/LC3-I and Beclin 1, and increased the expression of phosphorylation of AMPK. Simvastatin reduced the generation of autophagosomes and the ultrastructural injuries to myocardium. Conclusion. Perioperative statin therapy reduced myocardial injury by regulating myocardial autophagy and activating the phosphorylation of AMPK. The registration number of this study is ChiCTR-TRC-14005164.