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The heart produces but the lungs consume proinflammatory cytokines following cardiopulmonary bypass.
Eur J Cardiothorac Surg. 1999 Mar; 15(3):340-5.EJ

Abstract

OBJECTIVE

Proinflammatory cytokines, such as interleukin-6 (IL-6), and soluble adhesion molecules, such as E-selectin, may play an important role in patient response to cardiopulmonary bypass (CPB). We sought to define whether the heart and the lungs serve as important sources of these inflammatory mediators under clinical conditions of myocardial revascularization using CPB and cardioplegic arrest.

METHODS

Plasma levels of IL-6 and E-selectin were measured in coronary sinus (CS), arterial, pulmonary arterial (PA) and left atrial (LA) blood samples taken from 12 consecutive patients (68.3 +/- 11 years; five females) undergoing coronary artery bypass grafting (CABG). Blood samples were collected preoperatively, after reperfusion, and 1, 6, 12 and 18 h following surgery. CS and LA blood was drawn using transcutaneous catheters. PA artery blood was obtained through a Swan-Ganz catheter. Cytokine levels were determined by standard enzyme linked immunosorbent assay (ELISA) technique.

RESULTS

A mean of 3.8 +/- 1 coronary anastomoses were performed. The CPB time and aortic X-clamp time were 91 +/- 15 and 45 +/- 10 min, respectively. IL-6 levels increased significantly after CPB and peaked 6 h postoperatively. There was also a significant increase of E-selectin levels with an onset at 1 h and a peak at 12 h postoperatively. At all time points the IL-6 and E-selectin concentrations were significantly higher in the CS than in arterial blood. In contrast, the levels of both mediators measured in the LA were significantly lower than those in the PA.

CONCLUSION

The reperfusion of ischemic myocardium during CABG results in a significant increase in plasma levels of IL-6 and E-selectin. Our data indicate that the myocardium, but not the lungs, is a predominant source of IL-6 and E-selectin release following CPB. The lungs may consume rather than release those mediators during reperfusion. Not the CPB per se, but the myocardial ischemia seems to be crucial in the pathogenesis of the inflammatory response observed following open heart surgery.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, University of Regensburg, Germany. andreas.liebold@klinik.uni-regensburg.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10333033

Citation

Liebold, A, et al. "The Heart Produces but the Lungs Consume Proinflammatory Cytokines Following Cardiopulmonary Bypass." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 15, no. 3, 1999, pp. 340-5.
Liebold A, Keyl C, Birnbaum DE. The heart produces but the lungs consume proinflammatory cytokines following cardiopulmonary bypass. Eur J Cardiothorac Surg. 1999;15(3):340-5.
Liebold, A., Keyl, C., & Birnbaum, D. E. (1999). The heart produces but the lungs consume proinflammatory cytokines following cardiopulmonary bypass. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 15(3), 340-5.
Liebold A, Keyl C, Birnbaum DE. The Heart Produces but the Lungs Consume Proinflammatory Cytokines Following Cardiopulmonary Bypass. Eur J Cardiothorac Surg. 1999;15(3):340-5. PubMed PMID: 10333033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The heart produces but the lungs consume proinflammatory cytokines following cardiopulmonary bypass. AU - Liebold,A, AU - Keyl,C, AU - Birnbaum,D E, PY - 1999/5/20/pubmed PY - 1999/5/20/medline PY - 1999/5/20/entrez SP - 340 EP - 5 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 15 IS - 3 N2 - OBJECTIVE: Proinflammatory cytokines, such as interleukin-6 (IL-6), and soluble adhesion molecules, such as E-selectin, may play an important role in patient response to cardiopulmonary bypass (CPB). We sought to define whether the heart and the lungs serve as important sources of these inflammatory mediators under clinical conditions of myocardial revascularization using CPB and cardioplegic arrest. METHODS: Plasma levels of IL-6 and E-selectin were measured in coronary sinus (CS), arterial, pulmonary arterial (PA) and left atrial (LA) blood samples taken from 12 consecutive patients (68.3 +/- 11 years; five females) undergoing coronary artery bypass grafting (CABG). Blood samples were collected preoperatively, after reperfusion, and 1, 6, 12 and 18 h following surgery. CS and LA blood was drawn using transcutaneous catheters. PA artery blood was obtained through a Swan-Ganz catheter. Cytokine levels were determined by standard enzyme linked immunosorbent assay (ELISA) technique. RESULTS: A mean of 3.8 +/- 1 coronary anastomoses were performed. The CPB time and aortic X-clamp time were 91 +/- 15 and 45 +/- 10 min, respectively. IL-6 levels increased significantly after CPB and peaked 6 h postoperatively. There was also a significant increase of E-selectin levels with an onset at 1 h and a peak at 12 h postoperatively. At all time points the IL-6 and E-selectin concentrations were significantly higher in the CS than in arterial blood. In contrast, the levels of both mediators measured in the LA were significantly lower than those in the PA. CONCLUSION: The reperfusion of ischemic myocardium during CABG results in a significant increase in plasma levels of IL-6 and E-selectin. Our data indicate that the myocardium, but not the lungs, is a predominant source of IL-6 and E-selectin release following CPB. The lungs may consume rather than release those mediators during reperfusion. Not the CPB per se, but the myocardial ischemia seems to be crucial in the pathogenesis of the inflammatory response observed following open heart surgery. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/10333033/The_heart_produces_but_the_lungs_consume_proinflammatory_cytokines_following_cardiopulmonary_bypass_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/s1010-7940(99)00038-x DB - PRIME DP - Unbound Medicine ER -