SOLUBLE ADHESION MOLECULES IN REPERFUSION DURING CORONARY-BYPASS GRAFTING

Citation
R. Kalawski et al., SOLUBLE ADHESION MOLECULES IN REPERFUSION DURING CORONARY-BYPASS GRAFTING, European journal of cardio-thoracic surgery, 14(3), 1998, pp. 290-295
Citations number
25
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
10107940
Volume
14
Issue
3
Year of publication
1998
Pages
290 - 295
Database
ISI
SICI code
1010-7940(1998)14:3<290:SAMIRD>2.0.ZU;2-H
Abstract
Objective: Adhesion of activated leukocytes to the endothelial cells a s a result of myocardial ischaemia/reperfusion during open chest coron ary artery surgery has been shown to be involved in the development of tissue damage. Activated leukocytes adhere to endothelium via adhesio n molecules expressed by both cell types, resulting in the impairment of coronary capillary Bow. Upon cell activation, adhesion proteins may be released in the soluble form to circulating blood. The purpose of our study was to verify whether myocardial ischaemia/reperfusion occur ring during coronary artery bypass grafting results in release of the soluble adhesion molecules VCAM-1, ICAM-1, E-selectin and L-selectin i nto the circulation. Methods: Plasma levels of the soluble adhesion mo lecules were measured in vein, arterial and coronary sinus blood sampl es taken from 15 patients undergoing coronary artery bypass grafting ( CABG). Blood samples for estimations were collected during the procedu re: before aorta cross-clamping, at the beginning of reperfusion and 3 0 min after reperfusion. Soluble adhesion molecules levels were measur ed by standard ELISA assays. Results: Mean plasma levels of soluble VC AM-1 in arterial samples increased significantly at the beginning of r eperfusion and 30 min after reperfusion. In contrast, soluble L-select in plasma levels in arterial samples remained unchanged. In coronary s inus samples, levels of soluble ICAM-1 significantly increased 30 min after reperfusion. Moreover, in coronary sinus samples collected 30 mi n after reperfusion, soluble ICAM-1 levels were significantly higher t han in arterial samples obtained at the same time. The mean concentrat ion of soluble E-selectin in samples obtained from coronary sinus decr eased significantly 30 min after reperfusion. Moreover, plasma levels of soluble E-selectin in coronary sinus samples obtained 30 min after reperfusion were significantly decreased compared with these observed in arterial samples collected at the same time. Conclusions: The reper fusion of ischaemic myocardium during CABG results in a significant in crease in plasma levels of the soluble endothelial adhesion molecules VCAM-1 and ICAM-1 and significant decrease in soluble E-selectin plasm a levels. L-selectin plasma levels during CABG procedure remain unchan ged. We propose that the increased plasma concentrations of soluble VC AM-1 and ICAM-1 are a result of endothelial cell activation during isc haemia/reperfusion following bypass surgery. (C) 1998 Elsevier Science B.V. All rights reserved.