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On-pump versus off-pump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery.
Eur J Cardiothorac Surg. 2004 Jun; 25(6):985-92.EJ

Abstract

OBJECTIVES

The use of cardiopulmonary bypass in coronary artery bypass grafting (CABG) may contribute to the postoperative inflammatory response. The molecular chaperone heat-shock protein (HSP) 70 may be induced by ischemia, and has been detected both in the myocardium and in the circulation after CABG. In vitro, extracellular HSP70 may activate both innate and adaptive immunity. Hypothesizing that use of cardiopulmonary bypass (CPB) leads to more circulating HSP70, we explored the release of it in 10 patients undergoing CABG with the use of CPB, and in 10 patients undergoing off-pump surgery CABG (OPCAB).

METHODS

Blood samples were taken preoperatively, twice peroperatively, 2 and 6 h postoperatively and the next day. Serum analyses were performed by means of immunoassays.

RESULTS

We detected a significant difference in postoperative circulating HSP70 between on-pump and off-pump patients (median peaks of 2849 and 756 pg/ml, respectively, P < 0.01 2 h postoperatively). Interleukin-6 and -8 increased in all patients, without significant differences between the groups. Serum interleukin-10 increased at the end of the operation in 7 of 10 patients operated with cardiopulmonary bypass (median 51.7 pg/ml), but in none of the off-pump patients. Furthermore, in the first group, interleukin-10 correlated with the HSP70 concentration at the end of the operation, r = 0.75, P < 0.05. Serum markers of myocardial damage were higher in conventional than off-pump patients on day 1 postoperatively: median cardiac Troponin T was 0.358 and 0.126 microg/l, respectively, P < 0.01. Correspondingly, median creatine kinase-MB was 23.6 and 7.8 microg/l in on-pump and off-pump patients, respectively, P < 0.001. Peak HSP70 correlated with both Troponin T and creatine kinase-MB measured on day 1.

CONCLUSIONS

Significantly more HSP70 was released into the circulation following conventional than following off-pump CABG. Circulating HSP70 may indicate cellular stress or damage. Furthermore, HSPs are suggested as immunoregulatory agents, and may be important in the host defence postoperatively.

Authors+Show Affiliations

Faculty of Medicine, Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. brit.dybdahl@ulleval.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15144999

Citation

Dybdahl, Brit, et al. "On-pump Versus Off-pump Coronary Artery Bypass Grafting: More Heat-shock Protein 70 Is Released After On-pump Surgery." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 25, no. 6, 2004, pp. 985-92.
Dybdahl B, Wahba A, Haaverstad R, et al. On-pump versus off-pump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery. Eur J Cardiothorac Surg. 2004;25(6):985-92.
Dybdahl, B., Wahba, A., Haaverstad, R., Kirkeby-Garstad, I., Kierulf, P., Espevik, T., & Sundan, A. (2004). On-pump versus off-pump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 25(6), 985-92.
Dybdahl B, et al. On-pump Versus Off-pump Coronary Artery Bypass Grafting: More Heat-shock Protein 70 Is Released After On-pump Surgery. Eur J Cardiothorac Surg. 2004;25(6):985-92. PubMed PMID: 15144999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - On-pump versus off-pump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery. AU - Dybdahl,Brit, AU - Wahba,Alexander, AU - Haaverstad,Rune, AU - Kirkeby-Garstad,Idar, AU - Kierulf,Peter, AU - Espevik,Terje, AU - Sundan,Anders, PY - 2003/10/23/received PY - 2004/02/23/revised PY - 2004/03/02/accepted PY - 2004/5/18/pubmed PY - 2004/10/13/medline PY - 2004/5/18/entrez SP - 985 EP - 92 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 25 IS - 6 N2 - OBJECTIVES: The use of cardiopulmonary bypass in coronary artery bypass grafting (CABG) may contribute to the postoperative inflammatory response. The molecular chaperone heat-shock protein (HSP) 70 may be induced by ischemia, and has been detected both in the myocardium and in the circulation after CABG. In vitro, extracellular HSP70 may activate both innate and adaptive immunity. Hypothesizing that use of cardiopulmonary bypass (CPB) leads to more circulating HSP70, we explored the release of it in 10 patients undergoing CABG with the use of CPB, and in 10 patients undergoing off-pump surgery CABG (OPCAB). METHODS: Blood samples were taken preoperatively, twice peroperatively, 2 and 6 h postoperatively and the next day. Serum analyses were performed by means of immunoassays. RESULTS: We detected a significant difference in postoperative circulating HSP70 between on-pump and off-pump patients (median peaks of 2849 and 756 pg/ml, respectively, P < 0.01 2 h postoperatively). Interleukin-6 and -8 increased in all patients, without significant differences between the groups. Serum interleukin-10 increased at the end of the operation in 7 of 10 patients operated with cardiopulmonary bypass (median 51.7 pg/ml), but in none of the off-pump patients. Furthermore, in the first group, interleukin-10 correlated with the HSP70 concentration at the end of the operation, r = 0.75, P < 0.05. Serum markers of myocardial damage were higher in conventional than off-pump patients on day 1 postoperatively: median cardiac Troponin T was 0.358 and 0.126 microg/l, respectively, P < 0.01. Correspondingly, median creatine kinase-MB was 23.6 and 7.8 microg/l in on-pump and off-pump patients, respectively, P < 0.001. Peak HSP70 correlated with both Troponin T and creatine kinase-MB measured on day 1. CONCLUSIONS: Significantly more HSP70 was released into the circulation following conventional than following off-pump CABG. Circulating HSP70 may indicate cellular stress or damage. Furthermore, HSPs are suggested as immunoregulatory agents, and may be important in the host defence postoperatively. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/15144999/On_pump_versus_off_pump_coronary_artery_bypass_grafting:_more_heat_shock_protein_70_is_released_after_on_pump_surgery_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2004.03.002 DB - PRIME DP - Unbound Medicine ER -