Effect of tetrahydrobiopterin on selective endothelial dysfunction of epicardial porcine coronary arteries induced by cardiopulmonary bypass

Stevens, Louis-Mathieu; Fortier, Simon; Aubin, Marie-Claude; El-Hamamsy, Ismail; Maltais, Simon; Carrier, Michel; Perrault, Louis P.
September 2006
European Journal of Cardio-Thoracic Surgery;Sep2006, Vol. 30 Issue 3, p464
Academic Journal
Abstract: Background: We hypothesized that cardiopulmonary bypass induces a selective alteration of the coronary arterial endothelial cell signal transduction which could be explained by a state of depletion and/or decreased activity of endogenous tetrahydrobiopterin (BH4). The aim of this study was to assess the effects of cardiopulmonary bypass and BH4 on the endothelial function of epicardial coronary arteries in a swine model of cardiopulmonary bypass. Methods: Swine underwent 90min of cardiopulmonary bypass alone (N =19) or in association with a brief cardioplegic arrest with (N =6) or without (N =5) in vivo BH4 administration, followed by a 60-min period following weaning from cardiopulmonary bypass and were compared to a control group (N =7). Endothelium-dependent relaxations of epicardial coronary artery rings were studied using standard organ chamber experiments in the presence or absence of in vitro BH4 or superoxide dismutase (SOD) and catalase. Results: Cardiopulmonary bypass caused a statistically significant reduction of endothelium-dependent relaxations to serotonin (p <0.0001), bradykinin (p <0.001), UK14304 (p <0.0001) and calcium ionophore (p <0.01) in epicardial porcine coronary arteries. In vitro and in vivo BH4 supplementation improved endothelium-dependent relaxations to serotonin and bradykinin, which were left unchanged by SOD-catalase administration. Cardiopulmonary bypass was associated with a decrease in nitric oxide availability (p =0.002) and increased oxidative stress (p <0.001), which were both restored by in vivo BH4 administration (p <0.001). Conclusion: Treatment with BH4 improves the endothelial dysfunction of porcine epicardial coronary arteries, restores nitric oxide availability and reduces the oxidative stress associated with cardiopulmonary bypass.


Related Articles

  • Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures. van den Goor, J. M.; Saxby, B. K.; Tijssen, J. G.; Wesnes, K. A.; deMol, B. A.; Nieuwland, R. // Perfusion;Sep2008, Vol. 23 Issue 5, p267 

    Cardiac surgical procedures assisted by cardiopulmonary bypass (CPB) impair cognitive functions. Several studies, however, showed that cognitive functions were unaffected in patients undergoing either primary coronary artery bypass grafting (CABG) or more complex surgery assisted by CPB....

  • Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery. Koivisto, Simo-Pekka; Wistbacka, Jan-Ola; Rimpiläinen, Riikka; Nissinen, Juha; Loponen, Pertti; Teittinen, Kari; Biancari, Fausto // Perfusion;Mar2010, Vol. 25 Issue 2, p65 

    Objective: To review our results with the use of miniaturized cardiopulmonary bypass (Mini-CPB) versus conventional cardiopulmonary bypass (C-CPB) in high-risk patients (additive EuroSCORE≥6) who have undergone coronary artery bypass graft surgery (CABG). Patients and methods: This study...

  • Impact of avoiding cardiopulmonary bypass for coronary surgery on perioperative cardiac enzyme release and survival Kuduvalli, Manoj; Newall, Nick; Stott, Anthony; Grayson, Antony D.; Fabri, Brian M. // European Journal of Cardio-Thoracic Surgery;May2006, Vol. 29 Issue 5, p729 

    Abstract: Objective: This study examines the association between avoiding the use of cardiopulmonary bypass (CPB) for coronary surgery and postoperative cardiac enzyme (CE) release, and its subsequent impact on survival. Methods: Between January 1999 and September 2002, 3734 consecutive patients...

  • Total arterial revascularisation: effect of avoiding cardiopulmonary bypass on in-hospital mortality and morbidity in a propensity-matched cohort Pandey, Ragini; Grayson, Antony D.; Pullan, D. Mark; Fabri, Brian M.; Dihmis, Walid C. // European Journal of Cardio-Thoracic Surgery;Jan2005, Vol. 27 Issue 1, p94 

    Abstract: Objective: The combination of total arterial revascularisation and avoidance of cardiopulmonary bypass may provide additional benefits to patients receiving complete arterial grafting with cardiopulmonary bypass. We performed a propensity-matched cohort study of complete arterial...

  • Effect of cardiopulmonary bypass on lactate metabolism. Mustafa, Iqbal; Roth, Hubert; Hanafiah, Asikin; Hakim, Tarmizi; Anwar, Maizul; Siregar, Erwin; Leverve, Xavier M. // Intensive Care Medicine;Aug2003, Vol. 29 Issue 8, p1279 

    Objective: We have investigated the role of cardiopulmonary bypass on lactate metabolism in patients undergoing uncomplicated surgery for elective coronary artery bypass grafting (CABG).Design: Prospective non-randomized observational study.Settings:...

  • Base deficit in immediate postoperative period of coronary surgery with cardiopulmonary bypass and length of stay in intensive care unit. Hugot, Pierre; Sicsic, Jean-Charles; Schaffuser, Anne; Sellin, Michel; Corbineau, Hervé; Chaperon, Jacques; Ecoffey, Claude; Corbineau, Hervé // Intensive Care Medicine;Feb2003, Vol. 29 Issue 2, p257 

    Objective: To assess the relationship between the base deficit value in the immediate postoperative period of coronary surgery for cardiopulmonary bypass and the length of stay in the ICU.Design and Setting: Prospective descriptive study in the department of anesthesia...

  • Outcome after coronary artery bypass surgery with miniaturized versus conventional cardiopulmonary bypass. Rimpiläinen, R.; Biancari, F.; Wistbacka, J. O.; Loponen, P.; Koivisto, S. P.; Rimpiläinen, J.; Teittinen, K.; Nissinen, J. // Perfusion;Nov2008, Vol. 23 Issue 6, p361 

    We have reviewed the results of our experience with the use of miniaturized (Mini-CPB) versus conventional (C-CPB) cardiopulmonary bypass in coronary artery bypass surgery (CABG). This study included 365 patients who underwent CABG with C-CPB and 101 patients with Mini-CPB. In-hospital mortality...

  • Is cardiopulmonary bypass a reason for aspirin resistance after coronary artery bypass grafting? Zimmermann, Norbert; Kurt, Muhammed; Wenk, Angela; Winter, Joachim; Gams, Emmeran; Hohlfeld, Thomas // European Journal of Cardio-Thoracic Surgery;Apr2005, Vol. 27 Issue 4, p606 

    Abstract: Objective: ‘Off-pump’ coronary artery bypass grafting (OPCAB) is an alternative to conventional coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB). While midterm results after OPCAB have become available, systematic studies of changes in platelet...

  • Lipopolysaccharide Binding Protein and sCD14 are Not Produced as Acute Phase Proteins in Cardiac Surgery. Kudlova, Manuela; Kunes, Pavel; Kolackova, Martina; Lonsky, Vladimir; Mandak, Jiri; Andrys, Ctirad; Jankovicova, Karolina; Krejsek, Jan // Mediators of Inflammation;2007, Vol. 2007, Special section p1 

    Objectives. The changes in the serum levels of lipopolysaccharide binding protein (LBP) and sCD14 during cardiac surgery were followed in this study. Design. Thirty-four patients, 17 in each group, were randomly assigned to coronary artery bypass grafting surgery performed either with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics