Abstract 10368: Systemic Lipid Peroxydation and Myocardial Superoxide/Peroxynitrite Anions as Predictors of Post-Operative Outcome in Cardiac Surgery
Background: Coronary bypass grafting operation (CABG) is associated with a high rate of postoperative complications, that prolong patients' hospital stay. Myocardial oxidative stress plays an important role in the regulation of contractility and electrical properties of the heart; however its relationship with clinical outcome in patients undergoing CABG has not been explored.
Methods: In 248 patients undergoing elective CABG, right atrium appendages were obtained in order to determine resting and NADPH-stimulated myocardial O2- by lucigenin chemiluminescence, and myocardial peroxynitrite (ONOO-) by using urate inhibitable luminol chemiluminescence. Systemic oxidative stress was evaluated by measuring plasma malonyldihaldehyde (MDA). Patients were followed-up until their discharge from the hospital. Primary endpoints were the need for inotropic support and the length of hospital stay. Analyses were performed by cox-regression.
Results: High plasma MDA (A) as well as basal O2- (B), NADPH-stimulated O2- (C) and ONOO- (D) in atrial myocardium were associated with prolonged hospital stay. Both myocardial ONOO- (E) and NADPH-stimulated O2- were associated with the need and duration of inotropic support post-operatively (F).
Conclusions: Myocardial O2- (derived from NADPH-oxidase) and myocardial ONOO- are independent predictors of the length of hospital stay and post-operative inotropic support in patients undergoing CABG. These novel findings identify these markers of myocardial redox state as potential therapeutic targets for the prevention of post-operative complications after cardiac surgery.
- © 2011 by American Heart Association, Inc.