TITLE

Endothelial cell dysfunction after coronary artery bypass grafting with extracorporeal circulation in patients with type 2 diabetes mellitus

AUTHOR(S)
Lehle, Karla; Preuner, Jürgen G.; Vogt, Anja; Rupprecht, Leopold; Keyser, Andreas; Kobuch, Reinhard; Schmid, Christof; Birnbaum, Dietrich E.
PUB. DATE
October 2007
SOURCE
European Journal of Cardio-Thoracic Surgery;Oct2007, Vol. 32 Issue 4, p611
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Type 2 diabetes mellitus is a well-known risk factor in patients with severe coronary artery disease undergoing coronary artery bypass grafting (CABG). The aim of the study was to analyze the endothelial dysfunction in these patients by evaluating postoperative soluble inflammatory cytokines. Methods: Patients undergoing CABG without (n =15, group A) and with (n =14, group B) diabetes mellitus were analyzed for their release of E-selectin, interleukin-6 (IL-6), and tumor necrosis factor (TNF) up to 3 days postoperatively. A pharmacokinetic quantitative kinetic evaluation (Kinetica 2000) of maximum concentrations (c max), time to reach c max (t max), area under the curve (AUC0–inf), and terminal elimination half time (t 1/2) was performed using a non-compartmental model. Results: There was no difference in preoperative plasma concentrations of the cytokines and in the postoperative kinetic analyses of TNF when comparing both groups. However, the release of IL-6 was restricted with c max of 1055±543pg/ml for group B versus 2112±1532pg/ml for group A (p ≤0.05), paralleled by a decrease in the absolute amount (AUC0–inf) of IL-6. The t 1/2 remained unaffected (13.9±6.6h and 12.7±4.6h, respectively). The AUC0–inf of E-selectin decreased by a factor of 1.7 (p ≤0.05) with unchanged c max but reduced t 1/2 (12.9±10h for group B vs 33.1±20.4h for group A; p ≤0.01) referring to an augmented endothelial uptake and degradation of E-selectin. Conclusions: CABG with extracorporeal circulation could be used to verify a specific endothelial dysfunction in diabetic patients characterized by an impaired release of IL-6 and an increased turnover of E-selectin.
ACCESSION #
26488644

 

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