Oxidative Stress after Surgery on the Immature Heart

Fudulu, Daniel; Angelini, Gianni

doi:10.1155/2016/1971452

Cited by 33 publications

(20 citation statements)

References 96 publications

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“…Patients undergoing on-pump CABG surgery are affected by various ischemic stimuli: induction of cardioplegic arrest, microembolic events, reperfusion of the myocardium by surgical revascularization, and termination of cardioplegic arrest ( 18 ). There has been increasing evidence that the application of CPB using a heart-lung machine for open heart surgery may be the cause of some of this morbidity and is associated with pre- and postoperative stress responses, which triggers postoperative organ dysfunction ( 4 , 27 ). It is proposed that pretreatment with antioxidants such as Se could attenuate this inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…In coronary artery bypass graft (CABG) surgery, reperfusion of the ischemic heart causes myocardial injury, which is exacerbated by cardioplegic arrest. During reperfusion injury, neutrophils are activated and an inflammatory response is triggered, leading to cytokine release and reactive oxygen species (ROS) generation ( 1 - 4 ). The imbalance between the ROS products and the ability of antioxidants to neutralize them results in oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Low-dose Selenium on the Inflammatory Response in Coronary Artery Bypass Graft Surgery: A Clinical Trial

Sedighinejad

Imantalab

Mirmansouri

et al. 2016

Iran Red Crescent Med J

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BackgroundCoronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is suggested that selenium (Se), an essential trace element, has a protective role against oxidative stress. Decreased intraoperative Se levels might be an independent predictive factor for postoperative multiorgan failure. In spite of its proposed advantages, however, the optimal timing and dosage are not well known.ObjectivesTo determine whether 600 µg of intravenous Se administration before induction of anesthesia for CABG surgery could attenuate inflammatory reactions in an Iranian population.MethodsThis randomized triple-blind clinical trial took place in the department of cardiac surgery of an academic hospital affiliated with Guilan University of Medical Sciences (GUMS) from May 2015 to September 2015. Eighty-eight eligible patients scheduled for elective on-pump CABG surgery were divided into two groups using randomized fixed quadripartite blocks. They received either an intravenous bolus of 600 µg Se before induction of anesthesia, or normal saline as a placebo. We had four measurement time-points: just before induction of anesthesia (T0), immediately after the end of CPB (T1), 24 hours after surgery (T2), and 48 hours after surgery (T3). Interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) serum levels were measured using the enzyme-linked immunosorbent assay (ELISA).ResultsData from a total of 81 patients were analyzed: group S (n = 41) and group C (n = 40). There was no significant difference between the two groups with regard to baseline characteristics. In both groups, CPB caused markedly increased IL-6, TNF-α, and CRP plasma concentrations compared with baseline (P = 0.0001). However, the pattern of changes was not significantly different between group S (P = 0.068) and group C (P = 0.26). The IL-6 and TNF-α change trends were significant in each group (P=0.0001). However, comparing the two groups showed no significant difference. With regard to IL-6, there was no significant difference between the two groups at the time-points of T1 (P = 0.34), T2 (P = 0.17), and T3 (P = 0.056), and the same was found for TNF-α at T1 (P = 0.34), T2 (P = 0.17), and T3 (P = 0.056). With regard to CRP, the trend of the changes was significant in each group (P = 0.0001). However, comparing two groups showed a borderline significant difference between them at T1 (P = 0.039), but not at T2 (P = 0.075) or T3 (P = 0.11).ConclusionsThis study revealed that the administration of 600 μg of intravenous Se immediately before induction of anesthesia was safe, but when compared to a placebo, no predominant clinical effects or modifications in the systemic inflammatory response induced by on-pump CABG were observed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Low-dose Selenium on the Inflammatory Response in Coronary Artery Bypass Graft Surgery: A Clinical Trial

Sedighinejad

Imantalab

Mirmansouri

et al. 2016

Iran Red Crescent Med J

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“…This leads to graft dysfunction, like allograft rejection, delayed graft function, or primary nonfunction, as well as to endothelial and parenchymal cell injury [52,53]. To increase success of the heart transplantation, experimental studies have focused on the enrichment of antioxidative substrates in cardioplegia solution and pump prime solution [54][55][56][57][58][59], suggesting the importance of continuous research into antioxidants.…”

Section: Int J Mol Sci 2020 21 X For Peer Review 3 Of 19mentioning

confidence: 99%

Oxidative Stress-Responsive MicroRNAs in Heart Injury

Kura

Bačová

Kaločayová

et al. 2020

IJMS

137

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Reactive oxygen species (ROS) are important molecules in the living organisms as a part of many signaling pathways. However, if overproduced, they also play a significant role in the development of cardiovascular diseases, such as arrhythmia, cardiomyopathy, ischemia/reperfusion injury (e.g., myocardial infarction and heart transplantation), and heart failure. As a result of oxidative stress action, apoptosis, hypertrophy, and fibrosis may occur. MicroRNAs (miRNAs) represent important endogenous nucleotides that regulate many biological processes, including those involved in heart damage caused by oxidative stress. Oxidative stress can alter the expression level of many miRNAs. These changes in miRNA expression occur mainly via modulation of nuclear factor erythroid 2-related factor 2 (Nrf2), sirtuins, calcineurin/nuclear factor of activated T cell (NFAT), or nuclear factor kappa B (NF-κB) pathways. Up until now, several circulating miRNAs have been reported to be potential biomarkers of ROS-related cardiac diseases, including myocardial infarction, hypertrophy, ischemia/reperfusion, and heart failure, such as miRNA-499, miRNA-199, miRNA-21, miRNA-144, miRNA-208a, miRNA-34a, etc. On the other hand, a lot of studies are aimed at using miRNAs for therapeutic purposes. This review points to the need for studying the role of redox-sensitive miRNAs, to identify more effective biomarkers and develop better therapeutic targets for oxidative-stress-related heart diseases.

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“…This study demonstrated a very large effect size, with NO being associated with a 50% relative reduction in the incidence of LCOS compared to children receiving standard treatment (15% compared to 31%, p = 0.007). The fact that this effect size was greatest in patients less than 2 years of age has biological plausibility; the neonatal/infant myocardium is more vulnerable to reactive oxygen species [12].…”

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confidence: 98%