Document Detail

Detection of anti-hsp70 immunoglobulin G antibodies indicates better outcome in coronary artery bypass grafting patients suffering from severe preoperative angina.
MedLine Citation:
PMID:  15337014     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent findings indicate that molecular chaperones actively participate in myocardial cytoprotection. Moreover, ischemic tolerance can be induced in humans by brief ischemic events. Therefore, we investigated patients with severe angina attacks before coronary artery bypass grafting. We focused on appearance of anti-hsp70 antibodies as an immunologic response to heat shock protein induction by ischemia followed up by hemodynamic measurements perioperatively. We correlated these clinical findings with the presence of antibodies against hsp70 and the antioxidative capacity of patients' sera. METHODS: Thirty-five consecutive patients with coronary artery disease scheduled for coronary artery bypass grafting were included. Seventeen patients had severe angina, and 18 patients suffered from chronic stable angina preoperatively. In the patients' sera, antibodies against hsp70 were detected by enzyme-linked immunosorbent assay, and antioxidative capacity was detected using the chromogen assay. Cardiac output and pulmonary capillary wedge pressure were measured using a thermodilution catheter. We also evaluated C-reactive protein and creatine kinase MB isoenzyme, and performed a conventional leukocyte count. RESULTS: The sera of the 17 patients with severe angina attacks before surgery contained antibodies against hsp70 and a low antioxidative capacity. The interval between a severe angina attack and anti-hsp70 antibody titer are inversely correlated. These patients had better cardiac output and lower pulmonary capillary wedge pressure values after surgery. CONCLUSIONS: Severe angina before cardiac surgery coincided with an improved outcome as measured by hemodynamic variables as compared with chronic stable angina. This finding correlated significantly with a low antioxidative capacity and the presence of antibodies against hsp70. These pathophysiologic mechanisms might therefore play a role in myocardial protection.
Sebastian Vogt; Irene Portig; Björn Kusch; Sabine Pankuweit; Abdul Sami Sirat; Dirk Troitzsch; Bernhard Maisch; Rainer Moosdorf
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  78     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-31     Completed Date:  2005-07-11     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  883-9; discussion 889     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Philipps-University Hospital, Marburg, Germany.
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MeSH Terms
Angina, Unstable / classification,  immunology*,  physiopathology,  surgery*
Biological Markers / blood
C-Reactive Protein / metabolism
Cardiac Output
Chronic Disease
Coronary Artery Bypass / methods*
Creatine Kinase / metabolism
Creatine Kinase, MB Form
HSP70 Heat-Shock Proteins / immunology*
Immunoglobulin G / blood*
Isoenzymes / metabolism
Leukocyte Count
Middle Aged
Myocardium / metabolism*
Postoperative Period
Predictive Value of Tests
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/HSP70 Heat-Shock Proteins; 0/Immunoglobulin G; 0/Isoenzymes; 9007-41-4/C-Reactive Protein; EC Kinase; EC Kinase, MB Form

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