Academic Journal
Vasculoprotective role of del Nido cardioplegia in open-heart surgery via modulation of E-Selectin, Endocan, and TNF-alpha coronary sinus blood samples.
| Τίτλος: | Vasculoprotective role of del Nido cardioplegia in open-heart surgery via modulation of E-Selectin, Endocan, and TNF-alpha coronary sinus blood samples. |
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| Συγγραφείς: | Kızılyel F; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. fkizilyel@gmail.com., Cebe T; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Rum M; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Bozali K; Department of Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul, Turkey., Turgut Ş; Department of Medical Biochemistry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey., Yılmaz M; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Kehlibar T; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Ketenci B; Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. |
| Πηγή: | Journal of cardiothoracic surgery [J Cardiothorac Surg] 2025 Nov 28; Vol. 21 (1), pp. 30. Date of Electronic Publication: 2025 Nov 28. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BioMed Central Country of Publication: England NLM ID: 101265113 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-8090 (Electronic) Linking ISSN: 17498090 NLM ISO Abbreviation: J Cardiothorac Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BioMed Central, 2006- |
| Ιατρικοί όροι (MeSH): | Heart Arrest, Induced*/methods , Coronary Artery Bypass*/methods , Tumor Necrosis Factor-alpha*/blood , E-Selectin*/blood , Proteoglycans*/blood , Coronary Sinus*/metabolism , Neoplasm Proteins*/blood , Heart Valve Prosthesis Implantation*/methods, Biomarkers/blood ; Aortic Valve Stenosis/surgery ; Humans ; Male ; Female ; Aged ; Middle Aged ; Endothelium, Vascular |
| Περίληψη: | Purpose: Cardioplegia is routinely used in cardiac surgery to prevent endothelial damage associated with ischemia-reperfusion. However, there is no consensus on the optimal vasculoprotective cardioplegia. We aim to assess endothelial integrity using coronary sinus blood samples in patients who have received various types of cardioplegia. Methods: Aortic valve replacement for aortic stenosis and isolated coronary artery bypass grafting patients were included. del Nido and blood cardioplegias were subjected to assessment. Blood samples from the coronary sinus were collected before and after aortic cross-clamping. Endothelial and redox biomarkers were assessed utilizing immunochemical and colorimetric techniques. Results: In coronary artery bypass grafting patients, E-selectin levels were found significantly lower after cross-clamping compared to pre-clamp values, regardless of cardioplegia type (p = 0.015). ROC analysis revealed that Endocan, E-selectin, and TNF-α levels are reliable biomarkers of endothelial injury after cardiopulmonary bypass (p values: 0.004, 0.007, and < 0.001 for each parameter, respectively). Total oxidant status emerged as a significant redox biomarker, with 87% ROC sensitivity (p = 0.037). Conclusion: This study uniquely assesses localized endothelial responses via coronary sinus sampling with a multiplex biomarker panel, providing evidence of del Nido cardioplegia's protection. Our findings indicate that del Nido cardioplegia exhibits significant vasculoprotection, as evidenced by modulation of coronary sinus Endocan, E-selectin, and TNF-α. These biomarker changes, together with the absence of adverse differences in major postoperative outcomes, suggest that del Nido cardioplegia provides efficient myocardial and vascular protection in both aortic valve replacement and coronary artery bypass procedures, supporting its safe use in adult elective cardiac surgery. (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Competing interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
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| Grant Information: | 2022/109 Sağlık Bilimleri Üniversitesi |
| Contributed Indexing: | Keywords: Cardioplegia; Cardiopulmonary bypass; Endothelial damage; Redox homeostasis; Vasculoprotection |
| Substance Nomenclature: | 0 (ESM1 protein, human) 0 (Biomarkers) 0 (Tumor Necrosis Factor-alpha) 0 (E-Selectin) 0 (Proteoglycans) 0 (Neoplasm Proteins) |
| Entry Date(s): | Date Created: 20251129 Date Completed: 20260120 Latest Revision: 20260122 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12817490 |
| DOI: | 10.1186/s13019-025-03751-w |
| PMID: | 41316336 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1749-8090 |
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| DOI: | 10.1186/s13019-025-03751-w |