Activation of the Complement System During and After Cardiopulmonary Bypass Surgery

Bruins, Peter; Velthuis, Henk te; Yazdanbakhsh, Aria P.; Jansen, Piet; Hardevelt, F. W. J. Van; Beaumont, E. M. F. H. de; Wildevuur, Charles; Eijsman, L.; Trouwborst, A.; Hack, C. E.

doi:10.1161/01.cir.96.10.3542

Cited by 676 publications

(230 citation statements)

References 28 publications

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“…Preoperative CRP levels were similar in both groups, which is a finding consistent with the results of Bruins et al 14 Aviles and colleagues 3 have demonstrated the association between CRP and AF only in patients with persistent or chronic AF, not in patients with a single episode of short-term AF after surgery.…”

Section: Mandal Et Al Hsp60 Antibodies and Atrial Fibrillation 2589supporting

confidence: 88%

Association of Anti–Heat Shock Protein 65 Antibodies With Development of Postoperative Atrial Fibrillation

et al. 2004

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Background-Atrial fibrillation (AF) is a frequently encountered arrhythmia after cardiac surgery, but its underlying mechanisms are still unclear. We hypothesize that autoimmune and inflammatory responses against heat shock protein 65 (HSP65) may be involved and hence examined the relationship between HSP65 autoantibodies and occurrence of postoperative AF. Methods and Results-A prospective study of 329 patients undergoing elective primary CABG was undertaken.Cardiovascular risk factors, ECG characteristics, medications, and intraoperative and postoperative features were documented. Anti-HSP65 antibodies and C-reactive protein levels were measured in all preoperative blood samples with ELISA. Postoperative AF was defined as the characteristic arrhythmia, lasting for at least 15 minutes and confirmed on 12-lead ECG and occurring within the first postoperative week. This occurred in 62 patients (19%). In univariate analysis, HSP65 antibodies were significantly higher in patients with postoperative AF (Pϭ0.02). History of previous myocardial infarction, duration of bypass, number of distal anastomosis, and duration of ventilation were also associated with AF (PϽ0.05), but C-reactive protein levels were not (Pϭ0.

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Section: Mandal Et Al Hsp60 Antibodies and Atrial Fibrillation 2589supporting

confidence: 88%

Association of Anti–Heat Shock Protein 65 Antibodies With Development of Postoperative Atrial Fibrillation

et al. 2004

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“…The inflammatory process after CPB has its final lesion characterized by an increase of diffuse capillary permeability with significant liquid extravasation towards the interstitial tissue [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] . This finding could be partially explained by the presence of what is currently called endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, there is a stimulation of leukocytes, monocytes, macrophages, basophils, endothelial cells, myocytes and hepatocytes. There is an increase in the circulation of complement fractions (mainly C3a, C4a and C5a) 5,6 , citokynes (mainly tumor necrosis factoralpha, class 1, 6, 8 and 10 interleukins) [7][8][9] , histamine 10 and adhesion molecules 11. The inflammatory cascade is then amplified and may be associated with clinical manifestations by fever occurrences 12,13 , myocardial dysfunction (due to mechanical, ischemic and immunological injury) 14,15 and/or vasoplegy 16,17 , with occurrence of hypotension; signs of low cardiac output with hyperperfusion and tissular hypoxia; acute renal insufficiency 18,19 ; acute pulmonary lesion 20 , acute respiratory distress syndrome 21 ; blood dyscrasia 22 , neurological symptoms 23,24 and liquid retention with weight gain down to endothelial lesion 25 . When present, these manifestations may prolong the period of stay in ICU and in general hospital due to aggregated morbidity.…”

Section: Introductionmentioning

confidence: 99%

Perfil clínico da resposta inflamatória sistêmica após cirurgia cardíaca pediátrica com circulação extracorpórea

Soares¹,

Ribas²,

Spring³

et al. 2010

Arq. Bras. Cardiol.

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“…There is persistence of CRP, IL6, and TNF-a (tumor-necrosis factor-a) in paroxysmal AF long after successful cardioversion, perhaps indicating a causative role (Aviles et al, 2003). Increases of IL6, CRP, and the white blood cell count correlate with onset of AF after cardiac surgery (Bruins et al, 1997). Urgently admitted AF patients often have pneumonia (Lip et al, 1995).…”

Section: Insights Into Molecular Mechanisms Of Cardioembolic Ischemicmentioning

confidence: 99%

Gene Expression in Peripheral Blood Differs after Cardioembolic Compared with Large-Vessel Atherosclerotic Stroke: Biomarkers for the Etiology of Ischemic Stroke

Tang

Liu

et al. 2008

J Cereb Blood Flow Metab

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There are no biomarkers that differentiate cardioembolic from large-vessel atherosclerotic stroke, although the treatments differ for each and B30% of strokes and transient ischemic attacks have undetermined etiologies using current clinical criteria. We aimed to define gene expression profiles in blood that differentiate cardioembolic from large-vessel atherosclerotic stroke. Peripheral blood samples were obtained from healthy controls and acute ischemic stroke patients ( < 3, 5, and 24 h). RNA was purified, labeled, and applied to Affymetrix Human U133 Plus 2.0 Arrays. Expression profiles in the blood of cardioembolic stroke patients are distinctive from those of large-vessel atherosclerotic stroke patients. Seventy-seven genes differ at least 1.5-fold between them, and a minimum number of 23 genes differentiate the two types of stroke with at least 95.2% specificity and 95.2% sensitivity for each. Genes regulated in large-vessel atherosclerotic stroke are expressed in platelets and monocytes and modulate hemostasis. Genes regulated in cardioembolic stroke are expressed in neutrophils and modulate immune responses to infectious stimuli. This new method can be used to predict whether a stroke of unknown etiology was because of cardioembolism or large-vessel atherosclerosis that would lead to different therapy. These results have wide ranging implications for similar disorders.

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Activation of the Complement System During and After Cardiopulmonary Bypass Surgery

Cited by 676 publications

References 28 publications

Association of Anti–Heat Shock Protein 65 Antibodies With Development of Postoperative Atrial Fibrillation

Association of Anti–Heat Shock Protein 65 Antibodies With Development of Postoperative Atrial Fibrillation

Perfil clínico da resposta inflamatória sistêmica após cirurgia cardíaca pediátrica com circulação extracorpórea

Gene Expression in Peripheral Blood Differs after Cardioembolic Compared with Large-Vessel Atherosclerotic Stroke: Biomarkers for the Etiology of Ischemic Stroke

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