PMID- 19043395
OWN - NLM
STAT- MEDLINE
DCOM- 20090319
LR  - 20171116
IS  - 0021-9509 (Print)
IS  - 0021-9509 (Linking)
VI  - 49
IP  - 6
DP  - 2008 Dec
TI  - Exploring at the molecular level the effects of blood and blood-insulin 
      cardioplegias used during open-heart surgeries on myocardial prevention.
PG  - 809-16
AB  - AIM: The aim of this study was to measure the changes in the levels of soluble 
      adhesion molecules involved in acute inflammation during ischemia-reperfusion in 
      adults who underwent open-heart surgery using blood and blood-insulin 
      cardioplegia and to examine the differences in tissue damage at the molecular 
      level as a consequence of insulin's effect on myocardial energy metabolism. 
      METHODS: Non diabetic 36 patients were enrolled. Blood cardioplegia was used at 
      all cases; insulin and glucose were added at the study group. Blood samples were 
      taken from the coronary sinus and the radial artery before cross-clamp (T1), at 
      1st (T2) and 30th(T3) minutes after reperfusion. Soluble intercellular adhesion 
      molecules-1 (sICAM-1), soluble vascular adhesion molecules-1 (sVCAM-1), soluble 
      platelet/endothelial cells adhesion marker-1 (sPECAM-1) and serum lactate levels 
      were measured in these samples. Cardiac enzymes (CK-MB, troponin, and myoglobin) 
      were measured at postoperative 1th, 8th and 16th hours. The total duration of 
      mechanical ventilatory support during postoperative period, and the number of 
      days in the intensive care unit and hospital were recorded. RESULTS: No 
      significant differences were observed in sVCAM-1 levels in blood taken from the 
      radial artery at T1, T2 and T3 in either group. There were significant increases 
      between T1 and T3 and between T2 and T3 in samples obtained form the coronary 
      sinus (P=0.000 and P=0.003, respectively). Significant increases in sPECAM-1 in 
      samples obtained from both sites between T2 and T3 in both groups (P=0.000) were 
      observed. These differences were similar in both groups. Troponin levels at 8th 
      and 16th hours in the blood-insulin cardioplegia group were higher than the blood 
      cardioplegia group (P=0.003 and P=0.032, respectively). CONCLUSION: 
      Supplementation of blood cardioplegia with insulin did not yield a significant 
      improvement in adhesion molecules. Therefore, superiority of one cardioplegia 
      over the other in delivering myocardial protection during open-heart surgery has 
      not been shown.
FAU - Guzleoglu, M
AU  - Guzleoglu M
AD  - Department of Cardiovascular Surgery, Medical Faculty of Dokuz Eylul University, 
      Izmir, Turkey. mehmetguzeloglu@hotmail.com
FAU - Catalyurek, H
AU  - Catalyurek H
FAU - Oktay, G
AU  - Oktay G
FAU - Altun, Z
AU  - Altun Z
FAU - Silistireli, E
AU  - Silistireli E
FAU - Sariosmanoglu, N
AU  - Sariosmanoglu N
FAU - Acikel, U
AU  - Acikel U
FAU - Hazan, E
AU  - Hazan E
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - J Cardiovasc Surg (Torino)
JT  - The Journal of cardiovascular surgery
JID - 0066127
RN  - 0 (Cardioplegic Solutions)
RN  - 0 (Cell Adhesion Molecules)
RN  - 0 (Insulin)
RN  - 0 (Platelet Endothelial Cell Adhesion Molecule-1)
RN  - 0 (Troponin)
RN  - 0 (Vascular Cell Adhesion Molecule-1)
RN  - 33X04XA5AT (Lactic Acid)
SB  - IM
MH  - *Blood
MH  - Blood Specimen Collection
MH  - *Cardiac Surgical Procedures
MH  - *Cardioplegic Solutions
MH  - Cardiopulmonary Bypass
MH  - Cell Adhesion Molecules/*blood
MH  - Coronary Vessels
MH  - Female
MH  - *Heart Arrest, Induced/methods
MH  - Humans
MH  - *Insulin
MH  - Lactic Acid/blood
MH  - Male
MH  - Middle Aged
MH  - Myocardium/metabolism
MH  - Platelet Endothelial Cell Adhesion Molecule-1/blood
MH  - Radial Artery
MH  - Troponin/blood
MH  - Vascular Cell Adhesion Molecule-1/blood
EDAT- 2008/12/02 09:00
MHDA- 2009/03/20 09:00
CRDT- 2008/12/02 09:00
PHST- 2008/12/02 09:00 [pubmed]
PHST- 2009/03/20 09:00 [medline]
PHST- 2008/12/02 09:00 [entrez]
PST - ppublish
SO  - J Cardiovasc Surg (Torino). 2008 Dec;49(6):809-16.