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Published on: January 28, 2020
Another Marker of Inflammation and Oxidative Stress and Its Impact on Myocardial Function, Arterial Elastance, and
Teuku A Husain1,2, Johanes N E Putranto3,4, Philia Setiawan2,5
1Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.
Context:
Inflammatory and oxidative stress responses are markedly amplified following cardiopulmonary bypass (CPB), contributing to myocardial injury, vascular dysregulation, and potential multiorgan dysfunction.
Aims:
This study aimed to define how inflammatory, oxidative, and cellular stress responses quantified by tumor necrosis factor-alpha (TNF-α), hydroxyl (OH-) radical scavenging capacity, and heat shock protein-70 (HSP-70) relate to early postoperative myocardial contractility, arterial tone, and vasoactive-inotropic requirements after CPB.
Settings And Design:
A prospective cohort study was conducted in patients undergoing coronary artery bypass grafting (CABG) with preserved preoperative ejection fraction (EF).
Methods And Materials:
Postoperative biomarker levels and perioperative changes in TNF-α, OH- scavenging capacity, and HSP-70 with early myocardial contractility maximum rate of rise of left ventricular pressure (dP/dtmax), arterial elastance, and vasoactive-inotropic score were assessed.
Statistical Analysis Used:
Correlation analyses were performed using Pearson's or Spearman's correlation coefficients as appropriate.
Results:
A total of 52 patients were included in the study. Higher postoperative HSP-70 levels were associated with reduced early myocardial contractility (r = -0.315; P = 0.025) and increased vasoactive-inotropic requirements (ρ =0.341; P = 0.014). No significant associations were observed among postoperative biomarker variables, and changes in TNF-α or OH- scavenging capacity were not related to early postoperative hemodynamic outcomes (all P > 0.05).
Conclusions:
Early post-CPB myocardial dysfunction appears more closely associated with cellular stress (HSP-70) than with inflammatory or oxidative responses. Elevated HSP-70 levels in the early postoperative CABG may act as damage-associated molecular patterns associated with transient myocardial depression and higher vasoactive-inotropic requirements, whereas early inflammatory and oxidative changes showed no direct hemodynamic correlation.
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