Heparin Binding Protein in Adult Heart Surgery

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dc.contributor University of Helsinki, Clinicum en
dc.contributor University of Helsinki, University of Helsinki en
dc.contributor University of Helsinki, Department of Surgery en
dc.contributor University of Helsinki, Anestesiologian yksikkö en
dc.contributor University of Helsinki, Department of Surgery en
dc.contributor University of Helsinki, HUS Children and Adolescents en
dc.contributor University of Helsinki, Anestesiologian yksikkö en
dc.contributor.author Pesonen, Eero
dc.contributor.author Passov, Arie
dc.contributor.author Salminen, Ulla-Stina
dc.contributor.author Ilmakunnas, Minna
dc.contributor.author Vento, Antti
dc.contributor.author Aittomäki, Juha
dc.contributor.author Andersson, Sture
dc.contributor.author Schramko, Alexey
dc.date.accessioned 2020-03-26T03:25:28Z
dc.date.available 2020-06-04T21:00:41Z
dc.date.issued 2019-04
dc.identifier.citation Pesonen , E , Passov , A , Salminen , U-S , Ilmakunnas , M , Vento , A , Aittomäki , J , Andersson , S & Schramko , A 2019 , ' Heparin Binding Protein in Adult Heart Surgery ' , Annals of Thoracic Surgery , vol. 107 , no. 4 , pp. 1154-1159 . https://doi.org/10.1016/j.athoracsur.2018.10.007 en
dc.identifier.issn 0003-4975
dc.identifier.other PURE: 123964554
dc.identifier.other PURE UUID: 9764963c-27b6-49b0-8e2d-e33baf74150c
dc.identifier.other WOS: 000462308000046
dc.identifier.other Scopus: 85061902554
dc.identifier.uri http://hdl.handle.net/10138/313634
dc.description.abstract Background. Heparin binding protein (HBP) is released from neutrophilic secretory vesicles upon neutrophil adhesion on the endothelium. HBP mediates capillary hyperpermeability experimentally. In sepsis, HBP predicts organ dysfunction. Cardiopulmonary bypass induces neutrophil activation and hyperpermeability. We hypothesized that in cardiopulmonary bypass, HBP is released in the reperfused coronary circulation concomitantly with neutrophil adhesion. Methods. In 30 patients undergoing aortic valve replacement, concomitant blood samples were drawn from the coronary sinus and arterial line before aortic cross-clamping and 5 minutes after reperfusion to calculate transcoronary differences. Plasma HBP concentrations, neutrophil markers lactoferrin and myeloperoxidase, myocardial injury marker heart-type fatty acid binding protein, and leukocyte differential counts were measured. Results. Arterial HBP was 4.1 ng/mL (interquartile range [IQR], 3.6 to 5.3 ng/mL) preoperatively and 150.0 ng/mL (IQR, 108.2 to 188.6 ng/mL) after aortic declamping. HBP increased 39-fold, lactoferrin 16-fold, and myeloperoxidase fourfold during cardiopulmonary bypass. Before cardiopulmonary bypass, there were marginal transcoronary differences in HBP (1.4 ng/mL; IQR, -0.4 to 3.6 ng/mL; p = 0.001) and heart-type fatty acid binding protein (0.4 ng/mL; IQR, -0.04 to 3.5 ng/mL; p = 0.001) but not in the other indicators. During reperfusion, transcoronary HBP release (6.4 ng/mL; IQR, 1.8 to 13.7; ng/mL; p <0.001) was observed concomitantly with transcoronary neutrophil sequestration (-0.14 3 109/L; IQR, -0.28 to 0.01 3 109/L; p = 0.001) and transcoronary heart-type fatty acid binding protein release (6.9 ng/mL; IQR, 3.0 to 25.8 ng/mL; p <0.001). There were no transcoronary differences in lactoferrin or myeloperoxidase during reperfusion. Conclusions. Cardiopulmonary bypass results in substantial increase in circulating HBP. HBP is also released from the reperfused coronary circulation concomitantly with coronary neutrophil adhesion and myocardial injury. HBP may be one candidate for a humoral factor mediating capillary leak in cardiopulmonary bypass. (C) 2019 by The Society of Thoracic Surgeons en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Annals of Thoracic Surgery
dc.rights en
dc.subject CARDIOPULMONARY BYPASS en
dc.subject ORGAN DYSFUNCTION en
dc.subject ENDOTHELIUM en
dc.subject HBP/CAP37 en
dc.subject MARKER en
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology en
dc.title Heparin Binding Protein in Adult Heart Surgery en
dc.type Article
dc.description.version Peer reviewed
dc.date.embargoedUntil 2020-04-30
dc.identifier.doi https://doi.org/10.1016/j.athoracsur.2018.10.007
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/acceptedVersion
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