On-pump versus off-pump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery
| Autor: | Terje Espevik, Alexander Wahba, Anders Sundan, Rune Haaverstad, Idar Kirkeby-Garstad, Peter Kierulf, Brit Dybdahl |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Myocardial Ischemia Ischemia Creatine law.invention Hemoglobins chemistry.chemical_compound Coronary artery bypass surgery Troponin T law Internal medicine Cardiopulmonary bypass Creatine Kinase MB Form Humans Medicine HSP70 Heat-Shock Proteins Postoperative Period Derivation Coronary Artery Bypass Creatine Kinase Aged Off-pump coronary artery bypass Cardiopulmonary Bypass business.industry Interleukins General Medicine Middle Aged medicine.disease Surgery Isoenzymes Transplantation chemistry Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 25:985-992 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2004.03.002 |
| Popis: | Objectives: The use of cardiopulmonary bypass in coronary artery bypass grafting (CABG) may contribute to the postoperative inflammatory response. The molecular chaperone heat-shock protein (HSP) 70 may be induced by ischemia, and has been detected both in the myocardium and in the circulation after CABG. In vitro, extracellular HSP70 may activate both innate and adaptive immunity. Hypothesizing that use of cardiopulmonary bypass (CPB) leads to more circulating HSP70, we explored the release of it in 10 patients undergoing CABG with the use of CPB, and in 10 patients undergoing off-pump surgery CABG (OPCAB). Methods: Blood samples were taken preoperatively, twice peroperatively, 2 and 6 h postoperatively and the next day. Serum analyses were performed by means of immunoassays. Results: We detected a significant difference in postoperative circulating HSP70 between on-pump and off-pump patients (median peaks of 2849 and 756 pg/ml, respectively, P , 0:01; 2 h postoperatively). Interleukin-6 and -8 increased in all patients, without significant differences between the groups. Serum interleukin-10 increased at the end of the operation in 7 of 10 patients operated with cardiopulmonary bypass (median 51.7 pg/ml), but in none of the off-pump patients. Furthermore, in the first group, interleukin-10 correlated with the HSP70 concentration at the end of the operation, r ¼ 0:75; P , 0:05: Serum markers of myocardial damage were higher in conventional than off-pump patients on day 1 postoperatively: median cardiac Troponin T was 0.358 and 0.126 mg/l, respectively, P , 0:01: Correspondingly, median creatine kinase-MB was 23.6 and 7.8 mg/l in on-pump and off-pump patients, respectively, P , 0:01: Peak HSP70 correlated with both Troponin T and creatine kinase-MB measured on day 1. Conclusions: Significantly more HSP70 was released into the circulation following conventional than following off-pump CABG. Circulating HSP70 may indicate cellular stress or damage. Furthermore, HSPs are suggested as immunoregulatory agents, and may be important in the host defence postoperatively. q 2004 Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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