The Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut.
Beth Israel Deaconess Medical Center, Department of Medicine, Boston, Massachusetts.
Am J Cardiol. 2019 Mar 15;123(6):899-904. doi: 10.1016/j.amjcard.2018.12.019. Epub 2018 Dec 19.
Evidence is accumulating that cardiac apoptosis occurs and contributes to myocyte cell death during myocardial ischemia. Cardioplegia, defined as the temporary cessation of cardiac activity during cardiac surgery, is a clinically controlled condition with myocardial ischemia and reperfusion. Our goal was to determine whether the apoptotic biomarker caspase-3 p17 is elevated in the coronary sinus (CS) during cardioplegia and if any elevations were reflected in the peripheral venous (PV) blood. Levels of the necrotic biomarker cardiac troponin I (cTnI) and the inflammatory marker caspase-1 p20 were also quantified in CS and PV. Blood was drawn before and at the end of cardioplegia in PV and CS and levels of p20, p17, and cTnI were measured. cTnI, p20, and p17 PV levels were significantly elevated compared with the control population before and at the end of cardioplegia. PV levels of all 3 markers increased after cardioplegia. CS levels were higher than PV levels for all 3 markers at both time points. Our data are consistent with the occurrence of cardiac apoptosis and inflammation during cardioplegia, in addition to necrosis. The heart-derived markers contributed to the peripheral levels and suggest that measurement of PV biomarker concentrations can be used to gauge cardiac preservation.
证据表明，心肌缺血时心脏细胞凋亡发生并导致心肌细胞死亡。心脏停搏液是指心脏手术期间心脏活动的暂时停止，它是一种临床可控的心肌缺血再灌注状态。我们的目标是确定在心脏停搏期间冠状窦（CS）中是否存在凋亡生物标志物半胱氨酸天冬氨酸蛋白酶-3 p17 的升高，以及任何升高是否反映在周围静脉（PV）血液中。CS 和 PV 中还定量了坏死生物标志物肌钙蛋白 I（cTnI）和炎症标志物半胱氨酸天冬氨酸蛋白酶-1 p20 的水平。在 PV 和 CS 中在心脏停搏液之前和结束时抽取血液，并测量 p20、p17 和 cTnI 的水平。与心脏停搏液之前和结束时的对照组相比，cTnI、p20 和 p17 的 PV 水平显着升高。心脏停搏液后，所有 3 种标志物的 PV 水平均升高。CS 水平在这两个时间点均高于所有 3 种标志物的 PV 水平。我们的数据与心脏停搏期间发生的心肌细胞凋亡和炎症一致，除了坏死。心脏来源的标志物有助于外周水平，并表明测量 PV 生物标志物浓度可用于评估心脏保存。
