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Diazoxide may protect endothelial glycocalyx integrity during coronary artery bypass grafting
Ari Adolf Mennander1, Ahmed Shalaby, Niku Oksala
1Heart Center, Cardiac Research, Tampere University Hospital and Tampere University, Tampere, Finland. ari.mennander@sydankeskus.fi
Insights
Diazoxide treatment may reduce endothelial glycocalyx shedding during coronary artery bypass grafting (CABG). This study observed lower plasma hyaluronan and syndecan-1 levels in patients receiving diazoxide post-surgery.
Area of Science:
- Cardiovascular Surgery
- Endothelial Biology
- Pharmacology
Background:
- Plasma hyaluronan and syndecan-1 indicate endothelial glycocalyx shedding during ischemia and edema.
- Diazoxide, a K(ATP)-channel opener, is known to reduce myocardial edema in coronary artery bypass grafting (CABG).
Purpose of the Study:
- To investigate the effect of diazoxide on plasma hyaluronan and syndecan-1 levels during CABG.
- To assess if diazoxide influences endothelial glycocalyx shedding in CABG patients.
Main Methods:
- Blood samples for hyaluronan and syndecan-1 were collected from 13 patients undergoing CABG, with or without diazoxide.
- Electron microscopy of right atrium biopsies from 9 patients examined ultrastructural changes.
Main Results:
- Ultrastructural differences were noted pre-operatively, correlating with myocardial ischemia and edema severity.
- Patients receiving diazoxide showed a significant decrease in plasma hyaluronan and syndecan-1 post-surgery (p < 0.04).
- A significant correlation between plasma hyaluronan and syndecan-1 was found in the diazoxide group (p < 0.005).
Conclusions:
- Diazoxide may reduce endothelial glycocalyx shedding after CABG.
- The findings suggest a protective role for diazoxide in maintaining glycocalyx integrity during cardiac surgery.
Objectives:
Plasma hyaluronan and syndecan-1 levels represent shedding of the endothelium glycocalyx during ischemia and edema. Diazoxide, a K(ATP)-channel opener, has been shown to decrease myocardial edema during coronary artery bypass grafting (CABG). We evaluated whether diazoxide exerts an impact on plasma hyaluronan and syndecan-1 levels during CABG.
Design:
Representative blood samples for hyaluronan and syndecan-1, before, during and after surgery, were obtained in 13 out of 16 patients that had a history of stable coronary artery disease undergoing CABG with or without diazoxide. Electron microscopy from biopsies procured from the right atrium in 9 patients was performed to confirm ultrastructural differences among patients before and during CABG.
Results:
Ultrastructural differences were apparent between individual patients already before operation at base line reflecting differences in the severity of myocardial ischemia and edema. A significant decrease of hyaluronan and syndecan-1 values was observed in patients with diazoxide after surgery (p < 0.04). Significant correlation of plasma hyaluronan and syndecan-1 levels was observed in patients with diazoxide but not in controls (p < 0.005, Spearman rank rho).
Conclusion:
Diazoxide may have an impact on levels of peripheral plasma hyaluronan and syndecan-1 after CABG, suggesting decreased shedding of the endothelial glycocalyx layer.
