Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

Cardioplegic arrest and cardiopulmonary bypass (CP/CPB) are known to engender microvascular dysfunction in patients undergoing cardiac surgery. These effects are significantly varied by patient comorbidities including diabetes and hypertension. Both diabetes and hypertension are associated with wors...

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Main Authors: Meghamsh Kanuparthy, Rishik Manthana, Himanshu Kaushik, Kathy Xiang, Jad Hamze, David Marimekala, Jun Feng, Frank W. Sellke
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/13/2/409
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author Meghamsh Kanuparthy
Rishik Manthana
Himanshu Kaushik
Kathy Xiang
Jad Hamze
David Marimekala
Jun Feng
Frank W. Sellke
author_facet Meghamsh Kanuparthy
Rishik Manthana
Himanshu Kaushik
Kathy Xiang
Jad Hamze
David Marimekala
Jun Feng
Frank W. Sellke
author_sort Meghamsh Kanuparthy
collection DOAJ
description Cardioplegic arrest and cardiopulmonary bypass (CP/CPB) are known to engender microvascular dysfunction in patients undergoing cardiac surgery. These effects are significantly varied by patient comorbidities including diabetes and hypertension. Both diabetes and hypertension are associated with worse outcomes after cardiac surgery, partly related to increased microvascular complications. In this review, we examine several key facets of microvascular dysfunction after CP/CPB: microvascular endothelial and vasomotor dysfunction, altered gene and protein expression, endothelial adherens junction dysfunction, and programmed cell death as they relate to diabetes and hypertension. This review examines both classical techniques, including microvessel reactivity assays, and modern multiomic approaches to characterizing these microvascular changes.
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issn 2227-9059
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spelling doaj-art-739a9dd8dfa645b591e01cffd0199d902025-08-20T03:12:16ZengMDPI AGBiomedicines2227-90592025-02-0113240910.3390/biomedicines13020409Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and HypertensionMeghamsh Kanuparthy0Rishik Manthana1Himanshu Kaushik2Kathy Xiang3Jad Hamze4David Marimekala5Jun Feng6Frank W. Sellke7Division of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Cardiothoracic Surgery, Department of Surgery, Warren Alpert Medical School, Brown University, Providence, RI 02903, USACardioplegic arrest and cardiopulmonary bypass (CP/CPB) are known to engender microvascular dysfunction in patients undergoing cardiac surgery. These effects are significantly varied by patient comorbidities including diabetes and hypertension. Both diabetes and hypertension are associated with worse outcomes after cardiac surgery, partly related to increased microvascular complications. In this review, we examine several key facets of microvascular dysfunction after CP/CPB: microvascular endothelial and vasomotor dysfunction, altered gene and protein expression, endothelial adherens junction dysfunction, and programmed cell death as they relate to diabetes and hypertension. This review examines both classical techniques, including microvessel reactivity assays, and modern multiomic approaches to characterizing these microvascular changes.https://www.mdpi.com/2227-9059/13/2/409microvascular dysfunctiondiabeteshypertensioncardioplegiacardiopulmonary bypass
spellingShingle Meghamsh Kanuparthy
Rishik Manthana
Himanshu Kaushik
Kathy Xiang
Jad Hamze
David Marimekala
Jun Feng
Frank W. Sellke
Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
Biomedicines
microvascular dysfunction
diabetes
hypertension
cardioplegia
cardiopulmonary bypass
title Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
title_full Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
title_fullStr Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
title_full_unstemmed Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
title_short Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension
title_sort microvascular dysfunction following cardioplegic arrest and cardiopulmonary bypass impacts of diabetes and hypertension
topic microvascular dysfunction
diabetes
hypertension
cardioplegia
cardiopulmonary bypass
url https://www.mdpi.com/2227-9059/13/2/409
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