Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.

<h4>Background</h4>Experimental cardiac ischemia-reperfusion injury causes degradation of the glycocalyx and coronary washout of its components syndecan-1 and heparan sulfate. Systemic elevation of syndecan-1 and heparan sulfate is well described in cardiac surgery. Still, the events dur...

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Autores principales:	Arie Passov, Alexey Schramko, Ulla-Stina Salminen, Juha Aittomäki, Sture Andersson, Eero Pesonen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/18a50d08e77d467eaad0942048228ec3
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spelling	oai:doaj.org-article:18a50d08e77d467eaad0942048228ec32021-11-25T06:19:11ZEndothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.1932-620310.1371/journal.pone.0251747https://doaj.org/article/18a50d08e77d467eaad0942048228ec32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251747https://doaj.org/toc/1932-6203<h4>Background</h4>Experimental cardiac ischemia-reperfusion injury causes degradation of the glycocalyx and coronary washout of its components syndecan-1 and heparan sulfate. Systemic elevation of syndecan-1 and heparan sulfate is well described in cardiac surgery. Still, the events during immediate reperfusion after aortic declamping are unknown both in the systemic and in the coronary circulation.<h4>Methods</h4>In thirty patients undergoing aortic valve replacement, arterial concentrations of syndecan-1 and heparan sulfate were measured immediately before and at one, five and ten minutes after aortic declamping (reperfusion). Parallel blood samples were drawn from the coronary sinus to calculate trans-coronary gradients (coronary sinus-artery).<h4>Results</h4>Compared with immediately before aortic declamping, arterial syndecan-1 increased by 18% [253.8 (151.6-372.0) ng/ml vs. 299.1 (172.0-713.7) ng/ml, p < 0.001] but arterial heparan sulfate decreased by 14% [148.1 (135.7-161.7) ng/ml vs. 128.0 (119.0-138.2) ng/ml, p < 0.001] at one minute after aortic declamping. There was no coronary washout of syndecan-1 or heparan sulfate during reperfusion. On the contrary, trans-coronary sequestration of syndecan-1 occurred at five [-12.96 ng/ml (-36.38-5.15), p = 0.007] and at ten minutes [-12.37 ng/ml (-31.80-6.62), p = 0.049] after reperfusion.<h4>Conclusions</h4>Aortic declamping resulted in extracardiac syndecan-1 release and extracardiac heparan sulfate sequestration. Syndecan-1 was sequestered in the coronary circulation during early reperfusion. Glycocalyx has been shown to degrade during cardiac surgery. Besides degradation, glycocalyx has propensity for regeneration. The present results of syndecan-1 and heparan sulfate sequestration may reflect endogenous restoration of the damaged glycocalyx in open heart surgery.Arie PassovAlexey SchramkoUlla-Stina SalminenJuha AittomäkiSture AnderssonEero PesonenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251747 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Arie Passov Alexey Schramko Ulla-Stina Salminen Juha Aittomäki Sture Andersson Eero Pesonen Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
description	<h4>Background</h4>Experimental cardiac ischemia-reperfusion injury causes degradation of the glycocalyx and coronary washout of its components syndecan-1 and heparan sulfate. Systemic elevation of syndecan-1 and heparan sulfate is well described in cardiac surgery. Still, the events during immediate reperfusion after aortic declamping are unknown both in the systemic and in the coronary circulation.<h4>Methods</h4>In thirty patients undergoing aortic valve replacement, arterial concentrations of syndecan-1 and heparan sulfate were measured immediately before and at one, five and ten minutes after aortic declamping (reperfusion). Parallel blood samples were drawn from the coronary sinus to calculate trans-coronary gradients (coronary sinus-artery).<h4>Results</h4>Compared with immediately before aortic declamping, arterial syndecan-1 increased by 18% [253.8 (151.6-372.0) ng/ml vs. 299.1 (172.0-713.7) ng/ml, p < 0.001] but arterial heparan sulfate decreased by 14% [148.1 (135.7-161.7) ng/ml vs. 128.0 (119.0-138.2) ng/ml, p < 0.001] at one minute after aortic declamping. There was no coronary washout of syndecan-1 or heparan sulfate during reperfusion. On the contrary, trans-coronary sequestration of syndecan-1 occurred at five [-12.96 ng/ml (-36.38-5.15), p = 0.007] and at ten minutes [-12.37 ng/ml (-31.80-6.62), p = 0.049] after reperfusion.<h4>Conclusions</h4>Aortic declamping resulted in extracardiac syndecan-1 release and extracardiac heparan sulfate sequestration. Syndecan-1 was sequestered in the coronary circulation during early reperfusion. Glycocalyx has been shown to degrade during cardiac surgery. Besides degradation, glycocalyx has propensity for regeneration. The present results of syndecan-1 and heparan sulfate sequestration may reflect endogenous restoration of the damaged glycocalyx in open heart surgery.
format	article
author	Arie Passov Alexey Schramko Ulla-Stina Salminen Juha Aittomäki Sture Andersson Eero Pesonen
author_facet	Arie Passov Alexey Schramko Ulla-Stina Salminen Juha Aittomäki Sture Andersson Eero Pesonen
author_sort	Arie Passov
title	Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
title_short	Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
title_full	Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
title_fullStr	Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
title_full_unstemmed	Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
title_sort	endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/18a50d08e77d467eaad0942048228ec3
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Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.

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