Metabolomic profiling in patients undergoing Off-Pump or On-Pump coronary artery bypass surgeryReportar como inadecuado




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BMC Cardiovascular Disorders

, 17:93

Coronary artery disease

Abstract

BackgroundCoronary artery bypass surgery can be performed without Off-Pump or with cardiopulmonary bypass On-Pump. Extracorporeal circulation and cardioplegic arrest may cause alterations in the plasma metabolome. We assessed metabolomic changes in patients undergoing On-Pump or Off-Pump coronary artery bypass surgery.

MethodsWe assessed five analyte classes 41 acylcarnitines, 14 amino acids, 92 glycerophospholipids, 15 sphingolipids, sugars, lactate using a mass-spectrometry-based kit Biocrates AbsoluteIDQ ® p150 in paired arterial and coronary sinus blood obtained from 10 consecutive On-Pump and 10 Off-Pump patients. Cardioplegia for On-Pump was warm blood Calafiore. On-Pump outcomes were corrected for hemodilution through crystalloid priming.

ResultsDemographic data were equal in both groups with normal ejection fraction, renal and liver function. Patients received 2.25 ± 0.64 bypass grafts. All postoperative courses were uneventful. Of 164 measured metabolites, only 13 7.9% were altered by cardiopulmonary bypass. We found more long-chain acylcarnitines Off-Pump and more short-chain acylcarnitines On-Pump. Glycerophospholipids showed lower concentrations On-Pump and arginine as the only different amino acid Off-Pump. Interestingly, plasma arginine nitric oxide precursor concentration at the end of surgery correlated inversely with postoperative vasopressor need r = −0.7; p < 0.001. Assessing arterial-venous differences revealed phosphatidylcholine-production and acylcarnitine-consumption. These findings were unaffected by cardiopulmonary bypass, cardioplegia or temporary vessel occlusion during Off-Pump surgery.

ConclusionsCardiopulmonary bypass and warm blood cardioplegia cause only minor changes to the metabolomic profile of patients undergoing coronary artery bypass surgery. The observed changes affected mainly acylcarnitines. In addition, there appears to be a relationship between arginine and vasopressor need after bypass surgery.

KeywordsMetabolomics Cardiac surgery Vasopressor Electronic supplementary materialThe online version of this article doi:10.1186-s12872-017-0518-1 contains supplementary material, which is available to authorized users.





Autor: H. Kirov - M. Schwarzer - S. Neugebauer - G. Faerber - M. Diab - T. Doenst

Fuente: https://link.springer.com/







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