Stimulation of neutrophil integrin expression during coronary artery bypass grafting: Comparison of crystalloid and blood cardioplegic solutions

Objectives: This study was designed (1) to evaluate the influence of plasma obtained from patients undergoing coronary artery bypass grafting on L-sel ectin, CD11b, and CD18 expression on human neutrophils and (2) to determine the influence of the use of crystalloid or blood cardioplegia during bypas s grafting on plasma-mediated expression of adhesion molecules on polymorph onuclear neutrophils, Patients and methods: Patients undergoing coronary artery bypass grafting w ere divided into 2 groups to receive crystalloid or blood cardioplegic solu tions. Peripheral vein, radial artery, and coronary sinus blood samples wer e drawn at aortic crossclamping, aortic crossclamp release, and 30 minutes after reperfusion. Human neutrophils were incubated with patients' plasma, and the expression of CD11b, CD18, and L-selectin was determined with flow cytometry. Results: In patients receiving crystalloid cardioplegic solutions, plasma s amples collected from the coronary sinus at aortic clamp release and 30 min utes thereafter induced significantly higher expression of neutrophil CD11b and CD18 than plasma samples obtained from a peripheral vein or artery at the same time points. The expression of L-selectin on polymorphonuclear neu trophils was significantly reduced with plasma obtained 30 minutes after re perfusion as compared with samples collected at aortic crossclamp release. In the group receiving blood cardioplegia, no significant differences in CD 11b, CD18, or L-selectin expression were found. Conclusions: (1) Ischemia/reperfusion after coronary artery bypass grafting is associated with the release of factors capable of neutrophil activation from myocardium into the circulating blood. (2) The release of soluble sti muli for neutrophils during bypass grafting may be modified by the cardiopl egic solution.