Soluble Adhesion Molecules and Myocardial Injury during Coronary Artery Bypass Grafting

Wei, Minxin; Kuukasjärvi, Pekka; Laurikka, Jari; Kaukinen, S.; Iisalo, Pekka; Laine, Seppo; Tarkka, Matti

doi:10.1007/s00268-002-6595-y

Cited by 12 publications

(7 citation statements)

References 21 publications

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“…16 It has been reported that the inflammatory reaction is involved in myocardial ischemia-reperfusion injury. 17,18 Transcardiac sICAM-1 increases significantly after aortic declamping in CABG. 8 However, our data show no correlation between sICAM-1 levels and ischemic time, CPB time, or CK-MB levels.…”

Section: Discussionmentioning

confidence: 98%

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Wei

Laurikka²,

Kuukasjärvi³

et al. 2003

Asian Cardiovasc Thorac Ann

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Plasma levels of sE-selectin, sP-selectin, and sICAM-1 were measured before anesthesia and at 0.5, 4, and 20 hours after cardiopulmonary bypass in 37 men undergoing coronary artery bypass surgery. Plasma sE-selectin remained close to the preoperative levels. The levels of sP-selectin increased significantly from 46.5 +/- 15.3 ng x mL(-1) to 69.3 +/- 39.6 ng x mL(-1) at 0.5 hours, 84.1 +/- 45.5 ng x mL(-1) at 4 hours, and 79.6 +/- 35.5 ng x mL(-1) at 20 hours. Plasma sICAM-1 levels decreased 0.5 hours after cardiopulmonary bypass, recovered at 4 hours, and showed a significant increase at 20 hours. The changes in plasma levels of adhesion molecules did not correlate with the duration of bypass or aortic crossclamping, hemodynamics, or creatine kinase-MB levels. However, sE-selectin and sICAM-1 levels increased considerably more in patients who needed norepinephrine in the intensive care unit. These results indicate that the transient changes in plasma levels of soluble adhesion molecules are not associated with postoperative myocardial injury in low-risk coronary grafting, although they correlate with the need for a vasopressor.

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Section: Discussionmentioning

confidence: 98%

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Wei

Laurikka²,

Kuukasjärvi³

et al. 2003

Asian Cardiovasc Thorac Ann

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“…These agents stimulate lipid peroxidation of endothelial cells and myocyte membranes, causing cellular dysfunction, edema and cell death [46]. CPB is associated with increased levels of soluble adhesion molecules [47]. Higher levels of adhesion molecules are briefly expressed and return to normal within a few hours but they are believed to be responsible for the dysfunction of multiple organ systems observed in the postoperative period [47].…”

Section: Discussionmentioning

confidence: 99%

“…CPB is associated with increased levels of soluble adhesion molecules [47]. Higher levels of adhesion molecules are briefly expressed and return to normal within a few hours but they are believed to be responsible for the dysfunction of multiple organ systems observed in the postoperative period [47]. A relationship between adhesion molecule expression and inflammatory mediators has also been shown [48].…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Bypass during Cardiac Surgery Modulates Systemic Inflammation by Affecting Different Steps of the Leukocyte Recruitment Cascade

et al. 2012

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BackgroundIt is known that the use of a cardiopulmonary bypass (CPB) during cardiac surgery leads to leukocyte activation and may, among other causes, induce organ dysfunction due to increased leukocyte recruitment into different organs. Leukocyte extravasation occurs in a cascade-like fashion, including capturing, rolling, adhesion, and transmigration. However, the molecular mechanisms of increased leukocyte recruitment caused by CPB are not known. This clinical study was undertaken in order to investigate which steps of the leukocyte recruitment cascade are affected by the systemic inflammation during CPB.MethodsWe investigated the effects of CPB on the different steps of the leukocyte recruitment cascade in whole blood from healthy volunteers (n = 9) and patients undergoing cardiac surgery with the use of cardiopulmonary bypass (n = 7) or in off-pump coronary artery bypass-technique (OPCAB, n = 9) by using flow chamber experiments, transmigration assays, and biochemical analysis.ResultsCPB abrogated selectin-induced slow leukocyte rolling on E-selectin/ICAM-1 and P-selectin/ICAM-1. In contrast, chemokine-induced arrest and transmigration was significantly increased by CPB. Mechanistically, the abolishment of slow leukocyte rolling was due to disturbances in intracellular signaling with reduced phosphorylation of phospholipase C (PLC) γ2, Akt, and p38 MAP kinase. Furthermore, CPB induced an elevated transmigration which was caused by upregulation of Mac-1 on neutrophils.ConclusionThese data suggest that CPB abrogates selectin-mediated slow leukocyte rolling by disturbing intracellular signaling, but that the clinically observed increased leukocyte recruitment caused by CPB is due to increased chemokine-induced arrest and transmigration. A better understanding of the underlying molecular mechanisms causing systemic inflammation after CPB may aid in the development of new therapeutic approaches.

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“…Wei et al investigated the changes in the levels of soluble adhesion molecules perioperatively (sICAM-1, sPselectin, and sE-selectin) in patients undergoing CABG surgery with or without CPB. After cardiac surgery, sP-selectin and sICAM-1 levels increased in both groups of patients being higher in the on-pump group (37).…”

Section: Adhesion Molecules In Cardiac Surgerymentioning

confidence: 84%

Markers of endothelial dysfunction after cardiac surgery: Soluble forms of vascular-1 and intercellular-1 adhesion molecules

et al. 2009

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Endothelium forms an inner layer of vascular wall. It plays an important role in inflammatory process, regulation of vascular tone, and synthesis of thromboregulatory substances. Leukocyte and endothelium interactions during inflammation are regulated by different families of adhesion molecules. Increased levels of soluble forms of adhesion molecules have been detected in the circulating blood in conditions such as autoimmune diseases, transplant rejection, ischemia-reperfusion injury in addition to neutrophil- and endothelial membrane-bound forms reflecting the level of endothelial dysfunction. It is known that endothelial dysfunction is a risk factor for ischemic events such as stroke, myocardial infarction, unstable angina pectoris, ventricle fibrillation, necessity of revascularisation procedures, and death from cardiovascular reasons. Clinical studies showed that cardiac surgery has an impact on vascular endothelial function as well. The amount of endotheliumderived soluble forms of vascular-1 and intercellular-1 adhesion molecules increases after cardiopulmonary bypass suggesting endothelial dysfunction. However, further investigations are needed to be done to support the evidence that endothelial dysfunction proceeding heart surgery is one of the reasons of tissue ischemia-reperfusion injury.

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Soluble Adhesion Molecules and Myocardial Injury during Coronary Artery Bypass Grafting

Cited by 12 publications

References 21 publications

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Cardiopulmonary Bypass during Cardiac Surgery Modulates Systemic Inflammation by Affecting Different Steps of the Leukocyte Recruitment Cascade

Markers of endothelial dysfunction after cardiac surgery: Soluble forms of vascular-1 and intercellular-1 adhesion molecules

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