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J Thorac Cardiovasc Surg 2000;119:1270-1277
© 2000 The American Association for Thoracic Surgery

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

STIMULATION OF NEUTROPHIL INTEGRIN EXPRESSION DURING CORONARY ARTERY BYPASS GRAFTING: COMPARISON OF CRYSTALLOID AND BLOOD CARDIOPLEGIC SOLUTIONS

From the Cardiosurgery Department,^a J. Strus Hospital, and Department of Cardiology—Intensive Therapy,^b University of Medical Sciences, Poznan, Poland.

Address for reprints: Tomasz Siminiak, MD, PhD, FESC, Department Cardiology–Intensive Therapy, University Medical Sciences, ul Przybyszewskiego 49, PL 60-355 Poznan, Poland (E-mail: edeskur{at}polbox.com ).

Objectives: This study was designed (1) to evaluate the influence of plasma obtained from patients undergoing coronary artery bypass grafting on L-selectin, CD11b, and CD18 expression on human neutrophils and (2) to determine the influence of the use of crystalloid or blood cardioplegia during bypass grafting on plasma-mediated expression of adhesion molecules on polymorphonuclear neutrophils.
Patients and methods: Patients undergoing coronary artery bypass grafting were divided into 2 groups to receive crystalloid or blood cardioplegic solutions. Peripheral vein, radial artery, and coronary sinus blood samples were drawn at aortic crossclamping, aortic crossclamp release, and 30 minutes after reperfusion. Human neutrophils were incubated with patients’ plasma, and the expression of CD11b, CD18, and L-selectin was determined with flow cytometry.
Results: In patients receiving crystalloid cardioplegic solutions, plasma samples collected from the coronary sinus at aortic clamp release and 30 minutes thereafter induced significantly higher expression of neutrophil CD11b and CD18 than plasma samples obtained from a peripheral vein or artery at the same time points. The expression of L-selectin on polymorphonuclear neutrophils was significantly reduced with plasma obtained 30 minutes after reperfusion as compared with samples collected at aortic crossclamp release. In the group receiving blood cardioplegia, no significant differences in CD11b, CD18, or L-selectin expression were found.
Conclusions: (1) Ischemia/reperfusion after coronary artery bypass grafting is associated with the release of factors capable of neutrophil activation from myocardium into the circulating blood. (2) The release of soluble stimuli for neutrophils during bypass grafting may be modified by the cardioplegic solution.

This article has been cited by other articles:

				R. Kalawski, M. Majewski, E. Kaszkowiak, H. Wysocki, and T. Siminiak Transcardiac Release of Soluble Adhesion Molecules During Coronary Artery Bypass Grafting: Effects of Crystalloid and Blood Cardioplegia Chest, May 1, 2003; 123(5): 1355 - 1360. [Abstract] [Full Text] [PDF]