[Activation of endothelium in cardiac surgery: the circulating levels of soluble E-selectin as a marker of the activation of endothelium].

Cardiopulmonary bypass (CPB) is associated with a whole body inflammatory response which may have detrimental consequence resulting in post perfusion syndrome. Adhesion molecule E-selectin plays a pivotal role in the inflammatory response, especially in the interaction of endothelium and neutrophils. Soluble form of E-selectin (sE-selectin) is thought to be a marker of endothelial activation. To evaluate the activation of endothelium during CPB with heparin coated and un-coated extracorporeal circuits, we measured plasma levels of sE-selectin, tumor necrosis factor alpha (TNF alpha), and neutrophil elastase in 16 patients having coronary artery bypass grafting. sE-selectin plasma concentration increased during or after CPB. Significantly lower maximum levels of sE-selectin are observed in patients perfused with heparin coated extracorporeal circuits. Maximum values of sE-selectin correlated with plasma levels of TNF alpha and neutrophil elastase in each patient. These observations suggest that endothelium is activated by extracorporeal circulation in cardiac surgery, and this activation was attenuated by heparin coating of extracorporeal circuits.