Document Detail

Left heart pump-assisted myocardial revascularization favorably affects neutrophil apoptosis.
MedLine Citation:
PMID:  20012609     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Granulocyte apoptosis is a key control process in the clearance of neutrophils from inflammatory sites, and its rate is modulated by a number of inflammatory mediators. In this study, we investigated whether the use of left ventricular-assisted technique (LVA) in beating heart myocardial revascularization would exert less impact on neutrophil apoptosis compared with conventional cardiopulmonary bypass (CPB). METHODS: Forty consecutive patients who underwent myocardial revascularization were randomly assigned to LVA (group A, 21 patients) or CPB (group B, 19 patients). Blood samples for detection of interleukin-6, interleukin-8, and tumor necrosis factor-alpha were measured at baseline and at various time points postoperatively. Neutrophil apoptosis was detected by light microscopy as well as by the annexin-V assays together with the activity of caspase 3 on postoperative samples. RESULTS: Preoperative clinical and demographic data did not differ between the two groups. The two groups also were similar with respect to mortality, number of grafts performed, duration of extracorporeal circulation, and need for inotropes. However postoperatively, spontaneous apoptosis was significantly delayed in neutrophils from CPB patients compared with LVA patients. Neutrophils were activated, as indicated by increased surface expression of CD11b. Caspase 3 activity was found to be significantly reduced in neutrophils from CPB patients after 18 and 24 hours of culture. CONCLUSIONS: Patients who underwent beating heart myocardial revascularization with LVA show a better preserved neutrophil apoptosis than patients treated with the CPB.
Paolo Stassano; Luigi Di Tommaso; Mario Monaco; Generoso Mastrogiovanni; Antonino Musumeci; Antonio Contaldo; Paolo Pepino
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  World journal of surgery     Volume:  34     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  652-7     Citation Subset:  IM    
Cardiac Surgery Unit, University Federico II, School of Medicine, Naples, Italy.
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MeSH Terms
Analysis of Variance
Annexin A5 / blood
Apoptosis / physiology*
Cardiopulmonary Bypass / methods
Caspase 3 / blood
Chi-Square Distribution
Heart-Assist Devices*
Interleukin-6 / blood
Interleukin-8 / blood
Middle Aged
Myocardial Ischemia / blood,  physiopathology,  surgery*
Myocardial Revascularization / methods*
Neutrophils / physiology
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Tumor Necrosis Factor-alpha / blood
Reg. No./Substance:
0/Annexin A5; 0/Interleukin-6; 0/Interleukin-8; 0/Tumor Necrosis Factor-alpha; EC 3.4.22.-/Caspase 3

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