Matrix Metalloproteinase‐9 Production following Cardiopulmonary Bypass Was Not Associated with Pulmonary Dysfunction after Cardiac Surgery

Abstract

Background. Cardiopulmonary bypass (CPB) causes release of matrix metalloproteinase- (MMP-) 9, contributing to pulmonary infiltration and dysfunction. The aims were to investigate MMP-9 production and associated perioperative variables and oxygenation following CPB. Methods. Thirty patients undergoing elective cardiac surgery were included. Arterial blood was sampled at 6 sequential points (before anesthesia induction, before CPB and at 2, 4, 6, and 24 h after beginning CPB) for plasma MMP-9 concentrations by ELISA. The perioperative laboratory data and variables, including bypass time, PaO2/FiO2, and extubation time, were also recorded. Results. The plasma MMP-9 concentrations significantly elevated at 2–6 h after beginning CPB (P < 0.001) and returned to the preanesthesia level at 24 h (P = 0.23), with predominant neutrophil counts after surgery (P < 0.001). The plasma MMP-9 levels at 4 and 6 h were not correlated with prolonged CPB time and displayed no association with postoperative PaO2/FiO2, regardless of reduced ratio from preoperative 342.9 ± 81.2 to postoperative 207.3 ± 121.3 mmHg (P < 0.001). Conclusion. Elective cardiac surgery with CPB induced short-term elevation of plasma MMP-9 concentrations within 24 hours, however, without significant correlation with CPB time and postoperative pulmonary dysfunction, despite predominantly increased neutrophils and reduced oxygenation.

The Oak–Wood Extract Robuvit® Improves Recovery and Oxidative Stress after Hysterectomy: A Randomized, Double-blind, Placebo-Controlled Pilot Study

“…Various research groups described increased activities of MMP-9 in patients after surgery [50][51][52]. However, the increase of MMP-9 activities in our patients was significantly lower after four weeks of intervention with Robuvit compared to the placebo (p = 0.006).…”

Strategies for Pharmacological Organoprotection during Extracorporeal Circulation Targeting Ischemia-Reperfusion Injury

“…Indeed, it was detected that after CPB plasma MMP-9 levels were significantly elevated reaching control levels after about 24 h. As a consequence leucocyte counts were also increased. However, as described in the patient trial of Lin et al ( 2015 ) this was not associated with bypass time or pulmonary dysfunction. In contrast, another patient trial showed that elevated MMP-8 and MMP-9 levels are associated with impaired oxygenation and pulmonary dysfunction after CPB (Beer et al, 2015 ).…”

Metalloproteinases in Cardiac Surgery: A Systematic Review

“…A total of 20 relevant publications were retrieved for further assessment. Fifteen trials that enrolled a total of 431 participants met the inclusion criteria and were included in the systematic review [6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23]. Two review authors (F.J., G.F.S.)…”

“…Of the 15 studies included, 5 were prospective RCTs (n = 211) [6,7,16,18,19], and 1 was a retrospective observational study [23], whereas the remaining 9 were prospective observational NRCTs [11][12][13][14][15]17,[20][21][22]. All studies included patients submitted to cardiac surgery with CPB, but some better defined their population: seven studies enrolled patients undergoing CABG with CPB (n = 213) [7,[11][12][13][14]16,21], one study included patients submitted to off-pump or on-pump CABG [15], one enrolled patients submitted to pericardiectomy with CPB [23], and one included patients undergoing to CABG or valve replacement with CPB [6].…”

“…MMP levels were found to be significantly correlated with CPB in all included studies. MMP-9 levels were found to be increased after CPB start and during CPB [6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23]. It is particularly overexpressed both in the myocardial tissue and circulating in the bloodstream [11,14].…”