Cassandra Joffs, MD, Himali R. Gunasinghe, BS, Marlina M

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Presentation transcript:

Cardiopulmonary bypass induces the synthesis and release of matrix metalloproteinases Cassandra Joffs, MD, Himali R. Gunasinghe, BS, Marlina M. Multani, BS, B. Hugh Dorman, MD, PhD, John M. Kratz, MD, A. Jackson Crumbley, MD, Fred A. Crawford, MD, Francis G. Spinale, MD, PhD The Annals of Thoracic Surgery Volume 71, Issue 5, Pages 1518-1523 (May 2001) DOI: 10.1016/S0003-4975(01)02442-0 Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Systemic arterial plasma levels for MMP-8 were determined by enzyme-linked immunosorbent assay, which recognized the pro-enzyme and active form for this MMP species. MMP-8 levels rapidly increased at separation from cardiopulmonary bypass (CPB) (∗p < 0.0001) and returned to within normal levels by 30 minutes after cardiopulmonary bypass (Post CPB). The Annals of Thoracic Surgery 2001 71, 1518-1523DOI: (10.1016/S0003-4975(01)02442-0) Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Systemic arterial plasma levels for MMP-13 determined by enzyme-linked immunosorbent assay, which recognized the pro-enzyme. Pro-MMP-13 (Pro-MMP-13) levels increased from baseline after cross-clamp release (∗p < 0.002) and remained elevated after separation from cardiopulmonary bypass (CPB). Pro-MMP13 levels returned to within normal levels by 6 hours after cardiopulmonary bypass (Post CPB). The Annals of Thoracic Surgery 2001 71, 1518-1523DOI: (10.1016/S0003-4975(01)02442-0) Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Systemic arterial levels for pro-MMP-9 (Pro-MMP-9) increased significantly from baseline values at cross-clamp release (∗p < 0.001) and remained elevated until 30 minutes after cardiopulmonary bypass (Post CPB). Pro-MMP-9 levels tended to decrease toward normal values during the postoperative period, but there was significant variability in this response. The Annals of Thoracic Surgery 2001 71, 1518-1523DOI: (10.1016/S0003-4975(01)02442-0) Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Systemic arterial levels for Pro-MMP-2 (Pro-MMP-2) decreased from baseline values at cross-clamp release (∗p = 0.006). However, pro-MMP-2 levels increased from baseline at 6 hours after cardiopulmonary bypass (Post CPB) and remained elevated at 24 hours after cardiopulmonary bypass (∗p < 0.05). The Annals of Thoracic Surgery 2001 71, 1518-1523DOI: (10.1016/S0003-4975(01)02442-0) Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 To determine whether the myocardium is an important source of MMPs, the myocardial gradient was computed. This gradient became positive after cardiopulmonary bypass (Post CPB), suggesting bypass-induced proenzyme binding or activation across the myocardium. (n = 20, ∗∗p = 0.06; Pre CPB = before cardiopulmonary bypass.) The Annals of Thoracic Surgery 2001 71, 1518-1523DOI: (10.1016/S0003-4975(01)02442-0) Copyright © 2001 The Society of Thoracic Surgeons Terms and Conditions