Endothelial dysfunction and glycocalyx degradation in aortic surgery under moderate hypothermia and circulatory arrest

Diakova ML, Svirko YuS, Dymbrylova ON, Suslova TE, Podoksenov YuK, Panfilov DS, Kozlov BN. Endothelial dysfunction and glycocalyx degradation in aortic surgery under moderate hypothermia and circulatory arrest. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(2):170‑175. (In Russ.)
https://doi.org/10.17116/kardio202417021170

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze the markers of endothelial and glycocalyx degradation in aortic surgery under cardiopulmonary bypass (CPB), circulatory arrest (CA) and moderate hypothermia (28—30°C).

MATERIAL AND METHODS

The study included 15 patients with ascending aortic aneurysm aged 56±8.6 years. Ascending aorta replacement was performed under CPB, moderate hypothermia (28—30°C) and CA with unilateral antegrade cerebral perfusion. We analyzed biochemical markers of glycocalyx degradation (syndecan-1 (SDC-1), syndecan-2 (HSPG), hyaluronic acid) and endothelial dysfunction (angiopoietin-1 (Ang-1), endothelial cell specific molecule (ESM-1), endothelin-1 (ET-1)) before surgery, after CPB, 4 and 24 hours after surgery.

RESULTS

Hyaluronic acid increased by 275% early after CPB (p=0.006) and SDC-1 increased by 108.3%. HSPG increased by 26.7% and 23.4% in 4 and 24 hours after surgery, respectively. Markers of endothelial dysfunction changed in early postoperative period. ET-1 increased by 76% after 4 hours and by 49% after 24 hours. Direct correlations were found between the markers of endothelial and glycocalyx degradation and CPB time.

CONCLUSION

Ascending aortic surgery under CPB, CA and moderate hypothermia (28—30°C) is accompanied by increase in markers of glycocalyx degradation immediately after CPB and markers of endothelial dysfunction in early postoperative period. Severity of endothelial dysfunction and glycocalyx degradation directly correlates with CPB time.

Keywords:

glycocalyx

endothelium

cardiac surgery

cardiopulmonary bypass

circulatory arrest

hypothermia

Authors:

Diakova M.L.

Research Cardiology Institute — Tomsk National Research Medical Center

ORCID: 0000-0001-9353-7234

Svirko Yu.S.

Research Cardiology Institute — Tomsk National Research Medical Center

ORCID: 0000-0002-2258-3564

Dymbrylova O.N.

Research Cardiology Institute — Tomsk National Research Medical Center

ORCID: 0000-0002-3330-660X

Suslova T.E.

Research Cardiology Institute — Tomsk National Research Medical Center

ORCID: 0000-0001-9645-6720

Podoksenov Yu.K.

Research Cardiology Institute — Tomsk National Research Medical Center

ORCID: 0000-0002-8939-2340

Panfilov D.S.

Cardiology Research Institute, Tomsk National Research Medical Centre

ORCID: 0000-0003-2201-350X

Kozlov B.N.

Cardiology Research Institute, Tomsk National Research Medical Centre

ORCID: 0000-0002-0217-7737

Received:

15.03.2023

Accepted:

08.08.2023

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