Kardiyopulmoner Baypas Ameliyatının Zaman Aralıklarına Bağlı Olarak Sirküle Adropin, Elabela ve Nitrik Oksitin Düzeyine Etkisi

Year 2018, Volume: 21 Issue: 3, 204 - 210, 02.12.2018

Suna Aydın

Abstract

Giriş: Elabela ve adropin (nitrik oksit aracılı
etki), kalpte sentezlenen ve vasküler sistem homoeostazındaki rolü olan, son yıllarda
keşfedilen iki yeni hormondur. Bu nedenle, bu çalışmanın temel amacı, koroner
arter baypas grefti kullanılarak yapılan kardiyopulmoner baypasın farklı zaman
aralıklarında alınan kan örneklerinde adropin, elabela ve nitrik oksit
değişikliklerini incelemektir.

Hastalar ve
Yöntem: Bu çalışmada 20 sağlıklı birey ve kardiyopulmoner
baypas ameliyatı olan 15 hasta bulunmaktadır. Kan örnekleri kardiyopulmoner
baypas ameliyatı olan hastalardan; anestezi indüksiyonundan önce (T1),
baypastan önce (T2), çapraz kelepçe çıkarılmadan önce (T3), yoğun bakım
ünitesinde (T4), operasyon sonrası 24. saatte (T5), 48. saatte (T6) ve 72.
saatte (T7) alındı. Sağlıklı gönüllü kontrol grubundan bir kez kan örneği alındı.
Kan adropin, elabela ve nitrik oksit miktarları ELISA ile ölçüldü.

Bulgular: Kontrol adropin ve nitrik oksit kan değerleri T1’den elde
edilen adropin ve nitrik oksit kan değerleri ile karşılaştırıldığında; T1
süresince toplanan kan adropin ve nitrik oksit kan değerleri istatistiksel
olarak anlamlı şekilde düşüktü. T1’deki kan elabela ve laktat düzeyi
istatistiksel olarak anlamlı şekilde yüksekti. Bu artış hastalar yoğun bakım
ünitesine alınıncaya (T4) kadar devam etti. Operasyon sonrası 24. (T5), 48.
(T6) ve 72. (T7) saatlerinde alınan kan örneklerinde hem elabela hem de laktat
istatistiksel olarak anlamlı şekilde düştü.

Sonuç: Kardiyopulmoner baypas ameliyatının farklı zaman aralıklarında alınan
kan örneklerinde bu moleküllerin miktarlarındaki değişiklikler koroner arter
baypas ameliyatının izlenmesinde umut vericidir.

Keywords

Adropin, elabela, nitrik oksit, koroner baypas, greft

Effects of Cardiopulmonary Bypass Operation on Circulating Levels of Adropin, Elabela, and Nitric Oxide Depending on the Time Intervals

Abstract

Introduction:
Elabela and adropin (nitric
oxide-mediated effects) are two new hormones that are synthesized in the heart
and discovered in the last decade, which play a role in vascular system
homeostasis. Therefore, the main aim of this study was to examine the changes
of adropin, elabela, and nitric oxide in blood samples taken at various time
intervals during a coronary artery bypass graft using cardiopulmonary bypass.

Patients
and Methods: This study
included 20 healthy individuals and 15 patients undergoing cardiopulmonary
bypass surgery. Blood samples were taken from patients who had cardiopulmonary
bypass surgery before anesthesia induction (T1), before bypass (T2), before
removing the cross-clamp (T3), at the intensive care unit (T4), and at
postoperative 24 (T5), 48 (T6), and 72 hours (T7). A blood sample was taken
once from the healthy volunteer control group. Blood adropin, elabela, and
nitric oxide quantities were measured by ELISA.

Results:
When the
control adropin and nitric oxide blood values were compared with the adropin
and nitric oxide blood values obtained at T1, adropin and nitric oxide levels
in the blood collected during the T1 time interval were significantly lower.
Elabela and lactate levels in the blood at the T1 time interval were
significantly higher. In the blood samples taken at postoperative 24 (T5), 48
(T6), and 72 hours (T7), both blood elabela and blood lactate began to decrease
significantly.

Conclusion:
Significant
changes in the amount of these molecules in blood samples taken at various time
intervals during cardiopulmonary bypass operation are promising in the
monitoring of coronary artery bypass surgery.

Keywords

Adropin, elabela, nitric oxide, coronary artery bypass, graft

References

• 1. Roth GA, Huffman MD, Moran AE, Feigin V, Mensah GA, Naghavi M, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation 2015;132:1667-78.
• 2. Aydin S, Aydin S, Nesimi Eren M, Sahin I, Yilmaz M, Kalayci M, et al. The cardiovascular system and the biochemistry of grafts used in heart surgery. Springerplus 2013;2:612.
• 3. Stoney WS. Evolution of cardiopulmonary bypass. Circulation 2009;119:2844-53.
• 4. Fox AA, Marcantonio ER, Collard CD, Thoma M, Perry TE, Shernan SK, et al. Increased peak postoperative B-type natriuretic peptide predicts decreased longer-term physical function after primary coronary artery bypass graft surgery. Anesthesiology 2011;114:807-16.
• 5. Schaff HV, Mashburn JP, McCarthy PM, Torres EJ, Burnett JC. Natriuresis during and early after cardiopulmonary bypass: relationship to atrial natriuretic factor, aldosterone, and antidiuretic hormone. J Thorac Cardiovasc Surg 1989;98:979-86.
• 6. Kuntschen FR, Galletti PM, Hahn C. Glucose-insulin interactions during cardiopulmonary bypass. Hypothermia versus normothermia. J Thorac Cardiovasc Surg 1986;91:451-9.
• 7. Aydin S, Eren MN, Aydin S, Ozercan IH, Dagli AF. The bioactive peptides salusins and apelin-36 are produced in human arterial and venous tissues and the changes of their levels during cardiopulmonary bypass. Peptides 2012;37:233-9.
• 8. Kumar KG, Trevaskis JL, Lam DD, Sutton GM, Koza RA, Chouljenko VN, et al. Identification of adropin as a secreted factor linking dietary macronutrient intake with energy homeostasis and lipid metabolism. Cell Metab 2008;8:468-81.
• 9. Chng SC, Ho L, Tian J, Reversade B. ELABELA: a hormone essential for heart development signals via the apelin receptor. Dev Cell 2013;27:672-80.
• 10. Aydin S. Three new players in energy regulation: preptin, adropin and irisin. Peptides 2014;56:94-110.
• 11. Oruc CU, Akpinar YE, Dervisoglu E, Amikishiyev S, Salmaslıoglu A, Gurdol F, et al. Low concentrations of adropin are associated with endothelial dysfunction as assessed by flow-mediated dilatation in patients with metabolic syndrome. Clin Chem Lab Med 2017;55:139-44.
• 12. Widmer RJ, Lerman A. Endothelial dysfunction and cardiovascular disease. Glob Cardiol Sci Pract 2014;2014:291-308.
• 13. Lovren F, Pan Y, Quan A, Singh KK, Shukla PC, Gupta M, et al. Adropin is a novel regulator of endothelial function. Circulation 2010;122:S185-92.
• 14. Celik A, Balin M, Kobat MA, Erdem K, Baydas A, Bulut M, et al. Deficiency of a new protein associated with cardiac syndrome X; called adropin. Cardiovasc Ther 2013;31:174-8.
• 15. Wang Z, Yu D, Wang M, Wang Q, Kouznetsova J, Yang R, et al. Elabela-apelin receptor signaling pathway is functional in mammalian systems. Sci Rep 2015;5:8170.
• 16. Yang P, Read C, Kuc RE, Buonincontri G, Southwood M, Torella R, et al. Elabela/Toddler Is an Endogenous Agonist of the Apelin APJ Receptor in the Adult Cardiovascular System, and Exogenous Administration of the Peptide Compensates for the Downregulation of Its Expression in Pulmonary Arterial Hypertension. Circulation 2017;135:1160-73.
• 17. Kahraman A, Mutlu E, Aldağ M. ADMA, SDMA and L-arginine may be Novel Targets in Pharmacotherapy for Complications due to Cardiopulmonary Bypass. J Med Biochem 2017;36:8-17.
• 18. Aydin S, Eren MN, Kalayci M, Yilmaz M, Aydin S. Analysis of hemodynamics and biochemical profile during coronary artery bypass surgery using cardiopulmonary bypass. Heart Health Open Access 2014;1:1.
• 19. Aydin S, Kuloglu T, Aydin S, Eren MN. Changes in lactate and NUCB2/ nesfatin-1 before, during and after cardiopulmonary bypass. Ann Cardiovasc Surg 2018;1:1012.
• 20. Aydin S. A short history, principles, and types of ELISA, and our laboratory experience with peptide/protein analyses using ELISA. Peptides 2015;72:4-15.
• 21. Diodato M, Chedrawy EG. Coronary artery bypass graft surgery: the past, present, and future of myocardial revascularisation. Surg Res Pract 2014;2014:726158.
• 22. Head SJ, Kappetein AP. Coronary artery bypass grafting: the past, present, and the future. Eur Heart J 2013;34:2855-6.
• 23. Barr FE, Beverley H, VanHook K, Cermak E, Christian K, Drinkwater D, et al. Effect of cardiopulmonary bypass on urea cycle intermediates and nitric oxide levels after congenital heart surgery. J Pediatr 2003;142:26-30.
• 24. Brettner F, Chappell D, Schwartz L, Lukasz A, Kümpers P, Becker BF, et al. Vascular endothelial dysfunction during cardiac surgery: on-pump versus off-pump coronary surgery. Eur Surg Res 2017;58:354-68.
• 25. Sandoo A, van Zanten JJ, Metsios GS, Carroll D, Kitas GD. The endothelium and its role in regulating vascular tone. Open Cardiovasc Med J 2010;4:302-12.
• 26. Ruvolo G, Speziale G, Greco E, Tritapepe L, Mollace V, Nistico G, et al. Nitric oxide release during hypothermic versus normothermic cardiopulmonary bypass. Eur J Cardiothorac Surg 1995;9:651-4.
• 27. Ohata T, Sawa Y, Kadoba K, Kagisaki K, Suzuki K, Matsuda H. Role of nitric oxide in a temperature dependent regulation of systemic vascular resistance in cardiopulmonary bypass. Eur J Cardiothorac Surg 2000;18:342-7.
• 28. Hamdy NM, Suwailem SM, El-Mesallamy HO. Influence of vitamin E supplementation on endothelial complications in type 2 diabetes mellitus patients who underwent coronary artery bypass graft. J Diabetes Complications 2009;23:167-73.
• 29. Panagiotopoulos I, Palatianos G, Michalopoulos A, Chatzigeorgiou A, Prapas S, Kamper EF. Alterations in biomarkers of endothelial function following on-pump coronary artery revascularization. J Clin Lab Anal 2010;24:389-98.
• 30. Jacot JG, Wong JY. Endothelial injury induces vascular smooth muscle cell proliferation in highly localized regions of a direct contact co-culture system. Cell Biochem Biophys 2008;52:37-46.
• 31. Owens CD, Gasper WJ, Rahman AS, Conte MS. Vein graft failure. J Vasc Surg 2015;61:203-16.
• 32. Favero G, Paganelli C, Buffoli B, Rodella LF, Rezzani R. Endothelium and its alterations in cardiovascular diseases: life style intervention. Biomed Res Int 2014;2014:801896.
• 33. Öztürk E, Haydin S, Tanıdır İC, Özyılmaz İ, Ergül Y, Erek E, et al. Use of inhaled nitric oxide in pediatric cardiac intensive care unit. Turk Kardiyol Dern Ars 2016;44:196-202.
• 34. Quertermous T. Apelin and its g protein-coupled receptor regulate cardiac development as well as cardiac function. Dev Cell 2007;12:319-20.
• 35. Saribulbul O, Alat I, Coskun S, Apaydin AZ, Yagdi T, Kiliccioglu M, et al. The role of brain natriuretic peptide in the prediction of cardiac performance in coronary artery bypass grafting. Tex Heart Inst J 2003;30:298-304.