SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S10:5
THE HUMAN HEART RELEASES CARDIOTROPHIN-1AFTER CORONARY ARTERY BYPASS GRAFTING
WITH CARDIOPULMONARY BYPASS
Tian Yikui 1 , Ruan Xinhua 1 , Laurikka Jari 2 , Laine Seppo 2 , Tarkka Matti 2 , Wei Minxin 1
1) China 2) Finland
Objectives
Cardiotrophin-1 is closely linked to many cardiovascular diseases, such as myocardial infarction and heart failure,
and exhibits cardioprotective effect in ischemia-reperfusion injury. The present study was designed to investigate
the course of CT-1 in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass
(CPB), and to evaluate the relationship between plasma CT-1 levels and postoperative cardiac function.
Methods
Twenty-four patients undergoing elective CABG were studied. Radial artery blood samples were collected before
CPB, 5 and 20 min after reperfusion, and 1, 6, 12 and 24 h after CPB. Coronary sinus blood samples were
collected before CPB, 5 and 20 min after reperfusion. Plasma CT-1 levels were measured using the ELISA method.
Hemodynamic data were collected.
Results
Peripheral CT-1 levels did not change significantly postoperatively. Trans-myocardial CT-1 levels increased significantly
5 and 20 minutes after reperfusion as compared to baseline. A weak positive correlation (r=0.408, p=0.048) was
found between trans-myocardial CT-1 levels at 20 min after reperfusion and CI at 12 hours after CPB.
Conclusions
The heart secretes CT-1 after ischemic injury. Endogenous CT-1 might be cardioprotective to ischemia-reperfusion
injury in patients undergoing CABG, but the precise mechanism of this effect warrants further research.
S10:6
ACUTE KIDNEY INJURY FOLLOWING CORONARY ARTERY BYPASS SURGERY USING THE RIFLE CRITERIA
Helgadottir Solveig 1 , Indridason Olafur 2 , Sigurdsson Gisli 2 , Sigurjonsson Hannes 2 ,
Arnorsson Thorarinn 2 , Gudbjartsson Tomas 2
1) University of Iceland, 2) Landspitali University Hospital, Iceland
Introduction
Different rates of acute kidney injury (AKI) have been reported following open-heart surgery, ranging from 2 to 30%.
This can be explained by variable study populations and a lack of consensus on AKI-criteria. Using international
criteria we studied the incidence of AKI following CABG.
Material and methods
A retrospective study of all patients that underwent CABG in Iceland, in 2002-2006. Concomitant CABG procedures,
e.g. as part of valve procedures, were excluded. AKI was defined according to the RIFLE criteria, using pre- and
post-op creatinine levels.
Results
Of 569 patients, 97 (17%) had reduced estimated glomerular filtration rate (eGFR200 μmol/L. The mean pre- and post-op creatinine level of the
total study population was 92 and 104 μmol/L, respectively (p=0.0001). Ninety patients (15.8%) experienced AKI;
58 fell into RISK, 16 in INJURY and 16 in FAILURE categories. Patients with AKI were 4.1 yrs older (p=0.0001) and
had lower pre-op eGFR (72 vs. 80 mL/min/1.73m2, p=0.009). Female gender (28% vs. 16%, p=0.01), hypertension
(74% vs. 59%, p=0.01) and acute surgery (11% vs. 2%, p