Plasma endothelin-1 and circulating endothelial progenitor cell levels after cardiopulmonary bypass in children with congenital heart diseases: a preliminary study

Abstract

There are very few data on analytical biomarker levels in children with congenital heart disease (CHD) before and after cardiopulmonary bypass surgery. We conducted a preliminary study in the Pediatric Hospital of Medical Center IMSS Mexico, to evaluate plasma levels of endothelin-1 (ET-1) and circulating endothelial progenitor cells (CPEC) before and after correction surgery. 56 patients were included: 41 with CHD that required CPB and 15 controls with surgery other than CPB, which were stratified by age (infants, preschool-age-children, and school-age-children). Samples of peripheral blood were taken 24h before and 48h after surgery, cytokine levels (TNF/IL-1β/IL-6/IL-8/IL-10 and IL-12p70) and brachial-artery-flow-mediated dilation (BAFMD) were explored too. Demographic and clinical data were collected. BAFMD was evaluated by-Doppler-ultrasound, the percentage (%) and absolute number (N) of CPEC [CEC and EPC], ET-1 and cytokines concentrations were measured by flow-cytometry, radioimmunoassay and a Bead-Array-cytometric-system, respectively. The% and N of CEC[CD34 + / CD146 + / VEGFR2 + / CD133−] increased in infants versus their control group; and EPC[CD34 + / CD146 + / VEGFR2 + / CD133 +] were higher in the control group of infants versus patients. ET-1 levels were higher in patients than in controls (p = 0.002). N-CEC showed differences between 24 and 48 hours; BAFMD in CPB-preschool at 24H and 48H showed a significant difference. Higher levels of IL-6 and IL-8 were detected in CPB-school-age at 48H. This pilot study observed a significant increase in the levels of CEC and ET-1. To validate these data, subsequent studies should increase the sample size.