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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2021-01-01
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| 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 |
| collection | DOAJ |
| 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 |
| id | doaj-art-18a50d08e77d467eaad0942048228ec3 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-18a50d08e77d467eaad0942048228ec32025-08-20T02:01:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025174710.1371/journal.pone.0251747Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery.Arie PassovAlexey SchramkoUlla-Stina SalminenJuha AittomäkiSture AnderssonEero Pesonen<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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0251747&type=printable |
| spellingShingle | Arie Passov Alexey Schramko Ulla-Stina Salminen Juha Aittomäki Sture Andersson Eero Pesonen Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery. PLoS ONE |
| title | 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_short | Endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery. |
| title_sort | endothelial glycocalyx during early reperfusion in patients undergoing cardiac surgery |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0251747&type=printable |
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