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Published on: January 28, 2020
Changes in various forms of fibronectin in patients undergoing coronary artery bypass grafting with cardiopulmonary
Anna Lemańska-Perek1, Dorota Krzyżanowska-Gołąb2, Grzegorz Wysoczański3
1Department of Chemistry and Immunochemistry, Wroclaw Medical University, M. Sklodowskiej-Curie 48/50, 50-369, Wroclaw, Poland. anna.lemanska-perek@umw.edu.pl.
Insights
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) activates inflammatory responses. This study found fibronectin (FN) changes, fragmentation, and FN-fibrin complexes after CABG, suggesting FN
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Inflammation Research
Background:
- Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) can trigger a systemic inflammatory response.
- Fibronectin (FN), a crucial extracellular matrix protein, acts as an endogenous inflammatory mediator.
Purpose of the Study:
- To investigate alterations in cellular and plasma fibronectin (FN) levels during CABG with CPB.
- To assess FN fragmentation and the formation of FN-fibrin complexes post-surgery.
Main Methods:
- Analysis of cellular and plasma FN levels in 40 patients undergoing CABG with CPB.
- Evaluation of FN fragmentation and FN-fibrin complex formation.
- Multivariate regression analysis to identify factors influencing plasma FN levels.
Main Results:
- CPB was associated with significant changes in cellular and plasma FN levels.
- Intensified FN fragmentation and the presence of FN-fibrin complexes were observed in all patients.
- Arterial hypertension and CPB duration correlated with plasma FN levels post-surgery.
Conclusions:
- Changes in FN concentration, degradation, and complex formation suggest extracellular matrix remodeling and repair processes post-cardiac surgery.
- Fibronectin (FN) shows potential as a clinical marker for monitoring repair processes after CABG.
- CPB-induced inflammation and coagulation activation are linked to fibronectin alterations.
Abstract:
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) is associated with the transient activation of a systemic inflammatory response. Fibronectin (FN), an endogenous inflammatory mediator, is a key component of the extracellular matrix. This study aimed to detect changes in cellular and plasma FN levels, as well as its potential fragmentation or FN-fibrin complex formation, in 40 patients undergoing CABG with CPB. Our results indicate that CPB was associated with changes in the levels of cellular and plasma FN and with intensified FN fragmentation. Moreover, FN-fibrin complexes were detected in all patients, indicating activation of the coagulation process during CPB. In a multivariate regression analysis, a history of arterial hypertension and CPB duration influenced plasma FN levels at 6 h (β = -0.458, p = 0.001; -0.375, p = 0.008, respectively) and 12 h (β = -0.293, p = 0.026; -0.554, p = 0.000) after surgery. Alterations in FN concentration, intensified FN degradation, and the presence of FN-fibrin complexes after surgery may suggest that these changes are related to the remodelling of the extracellular matrix resulting from cardiac surgery and the associated repair processes. The results indicate that FN has clinical potential as a marker of repair processes.
