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
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.