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The Journal of Cardiovascular Surgery 2002 August;43(4):489-93

language: English

Sialic acid is an indicator of inflammation due to cardiopulmonary bypass but not myocardial damage

Berkan Ö. 1, Göl M. K. 2, Günay L. 3, Sagaban M. 1

1 Izmir ­State Hos­pital, Car­di­o­vas­cular Sur­gery Clinic, ­Izmir, ­Turkey
2 Türkiye ­Yüksek ­Ihtisas Hos­pital, Car­di­o­vas­cular Sur­gery ­Clinic, ­Ankara, ­Turkey
3 Cum­hu­riyet Uni­ver­sity Med­ical ­Faculty Car­di­oth­o­racic Sur­gery Depart­ment, ­Sivas, ­Turkey


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Back­ground. The aim of the ­present ­study was to inves­ti­gate ­whether ­serum ­sialic ­acid is asso­ciated ­with the inflam­ma­tory ­response of car­di­o­pul­mo­nary ­bypass (CPB) or not, ­since car­di­o­pul­mo­nary ­bypass is ­known to pro­duce a ­systemic inflam­ma­tory syn­drome.
­Methods. In 20 ­patients in ­whom elec­tive cor­o­nary ­bypass ­grafting was ­done, arte­rial and cor­o­nary ­sinus ­blood sam­pling was ­done simul­ta­ne­ously. The ­timing of sam­plings was 8-10 min­ ­after the insti­tu­tion of CPB, ­just ­before the appli­ca­tion of ­aortic ­clamping (T1) and 2 min ­after ­cross ­clamp ­removal (T2), ­when ­there was cor­o­nary cir­cu­la­tion, but no myo­car­dial acti­va­tion.
­Results. ­Sialic ­acid, CK-MB, lac­tate ­levels ­were sig­nif­i­cantly ­higher at T2 ­than ­those at T1 for ­both arte­rial and cor­o­nary ­sinus sam­ples. ­Increase at T2 ­time ­point for SA, CK-MB and ­lactic ­acid at cor­o­nary ­sinus ­were ­closely cor­re­lated ­with the ­systemic ­increase of ­these sub­stances ­also. Actu­ally, ­increase of ­systemic and cor­o­nary ­sinus CK-MB ­levels was ­also cor­re­lated ­with the dura­tion of ­aortic ­cross-­clamping and car­di­o­pul­mo­nary ­bypass. Prob­ably due to con­sump­tion, a neg­a­tive cor­re­la­tion ­with the ­decrease of ­fibrinogen at cor­o­nary ­sinus was ­found ­with the dura­tion of ­aortic ­cross-­clamping.
Con­clu­sions. Our ­study ­showed a ­strong and con­sis­tent asso­ci­a­tion ­between ­serum SA con­cen­tra­tion and the inflam­ma­tory pro­cess. ­There are pre­vious ­reports ­that ­show ­sialic ­acid ­levels asso­ciated ­with ­ischemic ­insult to myo­car­dium. We are ­able to ­show ­that ­serum TSA cor­re­lates ­well ­with ­some of the ­acute ­phase pro­teins but ­this was not ­true ­with ­ischemic ­markers ­after car­di­o­plegic ­arrest.

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