R. Kalawski et al., Stimulation of neutrophil activation during coronary artery bypass grafting: Comparison of crystalloid and blood cardioplegia, ANN THORAC, 71(3), 2001, pp. 827-831
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. During myocardial ischemia, activation of polymorphonuclear neu
trophils (PMNs) results in the production of free oxygen radicals, which in
crease myocardial injury. It has been shown that PMNs also produce nitric o
xide. It is not clear whether PMNs become activated as a result of their di
rect contact with ischemic/ reperfused myocardium or if PMN activation and
free oxygen radical production are effects of specific stimuli released dur
ing coronary artery bypass grafting (CABG). The aim of the current study wa
s to evaluate plasma-mediated neutrophil stimulation and production of supe
roxide anion (O-2(-)) and nitric oxide in patients undergoing CABG, and to
verify whether crystalloid and blood cardioplegia can modify such stimulati
on.
Methods. Coronary sinus, peripheral arterial, and venous plasma samples wer
e collected from 50 patients who underwent CABG and were divided into 2 equ
al groups which received either crystalloid or blood cardioplegia: directly
before myocardial ischemia and aortic cross-clamping; at the beginning of
reperfusion after aortic clamp release; and 30 minutes after reperfusion. O
-2(-), and nitric oxide production by PMN was evaluated by standard methods
.
Results. There was a significant (p < 0.05) increase in O-2 production by P
MN incubated with plasma obtained from the coronary sinus immediately after
reperfusion in patients receiving crystalloid cardioplegia compared to blo
od cardioplegia. No difference was observed in plasma stimulation of nitric
oxide production by FMN in the 2 groups of patients at different times dur
ing the procedure.
Conclusions. Cardioplegia may affect release of neutrophil-oriented stimuli
from ischemic myocardium and modify neutrophil activation during coronary
artery bypass grafting. (C) 2001 by The Society of Thoracic Surgeons.