Off-pump myocardial revascularization attenuates endothelin-1 expression in systemic, pulmonary, and coronary circulation

Abstract

In OPCAB group, ET-1 levels did not significantly vary between time points. In CABG group, ET-1 levels were significantly elevated vs. baseline in arterial: ART-T2 vs. ART-T0 (1.83 ± 1.81 vs. 0.76 ± 1.07 fmol/mL, p = 0.05), pulmonary: SG-T2 vs. SG-T0 (2.70 ± 2.75 vs. 0.39 ± 0.28 fmol/mL, p < 0.001) and SG-T3 vs. SG-T0 (1.56 ± 0.28 vs. 0.39 ± 0.28 fmol/mL, p < 0.001), and coronary circulation CS-T2 vs. CS-T1 (1.12 ± 0.49 vs. 0.27 ± 0.09 fmol/mL, p = 0.01). ET-1 levels were significantly higher in CABG group in all vascular compartments: ART-T2 (1.83 ± 1.81 vs. 0.17 ± 0.16 fmol/mL, p = 0.02), ART-T4 (0.99 ± 0.56 vs. 0.24 ± 0.12 fmol/mL, p = 0.01), SG-T1 (0.59 ± 0.15 vs. 0.25 ± 0.13 fmol/mL, p = 0.01), SG-T2 (2.70 ± 2.75 vs. 0.30 ± 0.24 fmol/mL, p = 0.004), SG-T3 (1.56 ± 0.28 vs. 0.35 ± 0.31 fmol/mL, p < 0.001), SG-T4 (1.34 ± 0.11 vs. 0.34 ± 0.16 fmol/mL, p < 0.001), and CS-T2 (1.12 ± 0.49 vs. 0.12 ± 0.12 fmol/mL, p = 0.004). Coronary sinus ET-1 level after CPB (CS-T2) in CABG group correlated positively with troponin-I level 24 h postoperatively (r(2) = 0.802, p = 0.02) CONCLUSION: Off-pump myocardial revascularization attenuates ET-1 expression in all investigated vascular compartments. Elevated coronary ET-1 levels after CPB in CABG group correlate with troponin-I levels 24 h postoperatively.

Does Preoperative Plasma Endothelin-1 Level Influences the Postoperative Events in Patients Undergoing Coronary Artery Bypass Grafting (CABG)? Revisiting Endothelin-1 Molecule in CABG Patients

“…4,13 Elevated plasma levels of ET-1 have been identified in several cardiovascular disease states, as well as during CABG operations requiring CPB. 14 An increased expression of ET-1 has also been shown in patients having risk factors for the development of CAD. As these factors also contribute to the postoperative outcome of the patients, theoretically ET-1 could be a surrogate for these outcome parameters.…”

“…4 13 Elevated plasma levels of ET-1 have been identified in several cardiovascular disease states, as well as during CABG operations requiring CPB. 14…”

“…Unić et al 14 in one of their researches evaluated the influence of CPB on ET-1 expression in various circulation compartments in patients undergoing myocardial revascularization. The authors demonstrated an elevated ET-1 level in on-pump patients that correlated with troponin-1 levels 24 hour postoperatively.…”

On- or Off-Pump Coronary Artery Bypass: What Is the Evidence?

“…In fact, there is growing concern that OPCAB may result in worsening long-term graft patency (29). Unić et al (30) found that some inflammatory cytokines were decreased in OPCAB than those in on-pump CABG, despite these cytokines being beneficial to graft patency. Raza et al (31) compared bilateral internal thoracic artery versus single internal thoracic artery grafting technique in CABG, and demonstrated that bilateral internal thoracic artery was associated with a 21% lower late mortality (68% confidence limits, 16-26% ), but more deep sternal wound infections; OPCAB and on-pump CABG had similar results (Table).…”