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Structural myocardial changes after coronary artery surgery.

F Eberhardt1, U Mehlhorn, K Larosé

  • 1University of Cologne, University of Halle, Germany. frank.eberhardt@medinf.mu-luebeck.de

European Journal of Clinical Investigation
|December 15, 2000
PubMed
Summary
This summary is machine-generated.

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Coronary artery bypass grafting (CABG) using cold crystalloid cardioplegia causes myocardial stunning. Structural changes like increased HSP-70i and ICAM-1 indicate stunning post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Molecular Biology

Background:

  • Postoperative myocardial stunning is a known complication after coronary artery bypass grafting (CABG).
  • The role of cold crystalloid cardioplegia in inducing myocardial changes requires further investigation.

Purpose of the Study:

  • To investigate the presence and extent of clinical, structural, and histochemical evidence of myocardial stunning in patients undergoing CABG with cold crystalloid cardioplegia.
  • To identify potential structural markers for myocardial stunning in a clinical setting.

Main Methods:

  • Left ventricular biopsies from 10 CABG patients were collected before and after cardiopulmonary bypass (CPB).
  • Biopsies were immunostained for heat-shock protein 70 (HSP-70i), intercellular adhesion molecule-1 (ICAM-1), and actin.

Related Experiment Videos

  • Adenosine triphosphate (ATP) levels and coronary sinus lactate production were measured.

    • Main Results:

    • Post-CPB biopsies showed increased HSP-70i and ICAM-1 expression, and disrupted actin patterns, unlike pre-CPB samples.
    • ATP levels decreased significantly post-CPB, with increased lactate production observed.
    • While echocardiography showed no functional decline, inotropic support was needed to maintain cardiac output.

    Conclusions:

    • Clinical and structural evidence of myocardial stunning was observed after CABG using cold crystalloid cardioplegia.
    • Elevated HSP-70i and ICAM-1 expression, along with altered actin structure, may serve as reliable markers for identifying myocardial stunning.