Abstract
Diffuse impairment of ventricular function after cardiac surgery may be related to the generation during reperfusion of the myocardium of free radicals derived from oxygen. Fifteen patients undergoing elective coronary bypass surgery were studied by previously described assays for peroxidised lipids and for isomerised lipids which were used as indices of free radical activity. Serial blood samples were obtained from systemic arterial, mixed venous, and coronary sinus catheters before, during, and after the ischaemic period. The patients underwent coronary artery surgery on cardiopulmonary bypass with a membrane oxygenator, relative hypothermia 30-34 degrees C, and intermittent cross-clamping of the aorta. During the ischaemic periods there were no significant changes in the indices of free radical activity. During the reperfusion phase there was a significant increase in free radical indices in arterial and mixed venous blood. A small rise in free radical indices in coronary venous blood was not statistically significant. These data indicate that free radical activity is increased in patients shortly after the cessation of cardiopulmonary bypass. The pattern of distribution between the different sampling sites suggests that much of the observed increase in isomerised and peroxidised lipids originates from tissues other than the myocardium.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bachur N. R., Gordon S. L., Gee M. V. Anthracycline antibiotic augmentation of microsomal electron transport and free radical formation. Mol Pharmacol. 1977 Sep;13(5):901–910. [PubMed] [Google Scholar]
- Borer J. S., Rosing D. R., Miller R. H., Stark R. M., Kent K. M., Bacharach S. L., Green M. V., Lake C. R., Cohen H., Holmes D. Natural history of left ventricular function during 1 year after acute myocardial infarction: comparison with clinical, electrocardiographic and biochemical determinations. Am J Cardiol. 1980 Jul;46(1):1–12. doi: 10.1016/0002-9149(80)90598-6. [DOI] [PubMed] [Google Scholar]
- Borow K. M., Green L. H., Mann T., Sloss L. J., Braunwald E., Collins J. J., Cohn L., Grossman W. End-systolic volume as a predictor of postoperative left ventricular performance in volume overload from valvular regurgitation. Am J Med. 1980 May;68(5):655–663. doi: 10.1016/0002-9343(80)90251-x. [DOI] [PubMed] [Google Scholar]
- Braunwald E., Kloner R. A. Myocardial reperfusion: a double-edged sword? J Clin Invest. 1985 Nov;76(5):1713–1719. doi: 10.1172/JCI112160. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burrell C. J., Blake D. R. Reactive oxygen metabolites and the human myocardium. Br Heart J. 1989 Jan;61(1):4–8. doi: 10.1136/hrt.61.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Doroshow J. H. Effect of anthracycline antibiotics on oxygen radical formation in rat heart. Cancer Res. 1983 Feb;43(2):460–472. [PubMed] [Google Scholar]
- Ferreira R., Llesuy S., Milei J., Scordo D., Hourquebie H., Molteni L., de Palma C., Boveris A. Assessment of myocardial oxidative stress in patients after myocardial revascularization. Am Heart J. 1988 Feb;115(2):307–312. doi: 10.1016/0002-8703(88)90475-9. [DOI] [PubMed] [Google Scholar]
- Forman M. B., Puett D. W., Cates C. U., McCroskey D. E., Beckman J. K., Greene H. L., Virmani R. Glutathione redox pathway and reperfusion injury. Effect of N-acetylcysteine on infarct size and ventricular function. Circulation. 1988 Jul;78(1):202–213. doi: 10.1161/01.cir.78.1.202. [DOI] [PubMed] [Google Scholar]
- Fridovich I. Superoxide radical: an endogenous toxicant. Annu Rev Pharmacol Toxicol. 1983;23:239–257. doi: 10.1146/annurev.pa.23.040183.001323. [DOI] [PubMed] [Google Scholar]
- Fuster V., Gersh B. J., Giuliani E. R., Tajik A. J., Brandenburg R. O., Frye R. L. The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol. 1981 Mar;47(3):525–531. doi: 10.1016/0002-9149(81)90534-8. [DOI] [PubMed] [Google Scholar]
- Garlick P. B., Davies M. J., Hearse D. J., Slater T. F. Direct detection of free radicals in the reperfused rat heart using electron spin resonance spectroscopy. Circ Res. 1987 Nov;61(5):757–760. doi: 10.1161/01.res.61.5.757. [DOI] [PubMed] [Google Scholar]
- Guarnieri C., Ferrari R., Visioli O., Caldarera C. M., Nayler W. G. Effect of alpha-tocopherol on hypoxic-perfused and reoxygenated rabbit heart muscle. J Mol Cell Cardiol. 1978 Oct;10(10):893–906. doi: 10.1016/0022-2828(78)90336-x. [DOI] [PubMed] [Google Scholar]
- Gutteridge J. M. Free-radical damage to lipids, amino acids, carbohydrates and nucleic acids determined by thiobarbituric acid reactivity. Int J Biochem. 1982;14(7):649–653. doi: 10.1016/0020-711x(82)90050-7. [DOI] [PubMed] [Google Scholar]
- Halliwell B., Gutteridge J. M. The importance of free radicals and catalytic metal ions in human diseases. Mol Aspects Med. 1985;8(2):89–193. doi: 10.1016/0098-2997(85)90001-9. [DOI] [PubMed] [Google Scholar]
- Hammerschmidt D. E., Stroncek D. F., Bowers T. K., Lammi-Keefe C. J., Kurth D. M., Ozalins A., Nicoloff D. M., Lillehei R. C., Craddock P. R., Jacob H. S. Complement activation and neutropenia occurring during cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1981 Mar;81(3):370–377. [PubMed] [Google Scholar]
- Hearse D. J., Tosaki A. Free radicals and calcium: simultaneous interacting triggers as determinants of vulnerability to reperfusion-induced arrhythmias in the rat heart. J Mol Cell Cardiol. 1988 Mar;20(3):213–223. doi: 10.1016/s0022-2828(88)80054-3. [DOI] [PubMed] [Google Scholar]
- Hess M. L., Manson N. H. Molecular oxygen: friend and foe. The role of the oxygen free radical system in the calcium paradox, the oxygen paradox and ischemia/reperfusion injury. J Mol Cell Cardiol. 1984 Nov;16(11):969–985. doi: 10.1016/s0022-2828(84)80011-5. [DOI] [PubMed] [Google Scholar]
- Hess M. L., Okabe E., Kontos H. A. Proton and free oxygen radical interaction with the calcium transport system of cardiac sarcoplasmic reticulum. J Mol Cell Cardiol. 1981 Aug;13(8):767–772. doi: 10.1016/0022-2828(81)90258-3. [DOI] [PubMed] [Google Scholar]
- Hultgren H. N., Miyagawa M., Buch W., Angell W. W. Ischemic myocardial injury during cardiopulmonary bypass surgery. Am Heart J. 1973 Feb;85(2):167–176. doi: 10.1016/0002-8703(73)90457-2. [DOI] [PubMed] [Google Scholar]
- Iversen S. A., Cawood P., Dormandy T. L. A method for the measurement of a diene-conjugated derivative of linoleic acid, 18:2(9,11), in serum phospholipid, and possible origins. Ann Clin Biochem. 1985 Mar;22(Pt 2):137–140. doi: 10.1177/000456328502200204. [DOI] [PubMed] [Google Scholar]
- Johnson R. A., Baker S. S., Fallon J. T., Maynard E. P., 3rd, Ruskin J. N., Wen Z., Ge K., Cohen H. J. An occidental case of cardiomyopathy and selenium deficiency. N Engl J Med. 1981 May 14;304(20):1210–1212. doi: 10.1056/NEJM198105143042005. [DOI] [PubMed] [Google Scholar]
- Kirklin J. K., Westaby S., Blackstone E. H., Kirklin J. W., Chenoweth D. E., Pacifico A. D. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1983 Dec;86(6):845–857. [PubMed] [Google Scholar]
- Korthuis R. J., Smith J. K., Carden D. L. Hypoxic reperfusion attenuates postischemic microvascular injury. Am J Physiol. 1989 Jan;256(1 Pt 2):H315–H319. doi: 10.1152/ajpheart.1989.256.1.H315. [DOI] [PubMed] [Google Scholar]
- Lunec J., Dormandy T. L. Fluorescent lipid-peroxidation products in synovial fluid. Clin Sci (Lond) 1979 Jan;56(1):53–59. doi: 10.1042/cs0560053. [DOI] [PubMed] [Google Scholar]
- Manning A. S., Coltart D. J., Hearse D. J. Ischemia and reperfusion-induced arrhythmias in the rat. Effects of xanthine oxidase inhibition with allopurinol. Circ Res. 1984 Oct;55(4):545–548. doi: 10.1161/01.res.55.4.545. [DOI] [PubMed] [Google Scholar]
- McCord J. M. Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med. 1985 Jan 17;312(3):159–163. doi: 10.1056/NEJM198501173120305. [DOI] [PubMed] [Google Scholar]
- Muus P., Bonta I. L., den Oudsten S. A. Plasma levels of malondialdehyde, a product of cyclo-oxygenase-dependent and independent lipid peroxidation in rheumatoid arthritis: a correlation with disease activity. Prostaglandins Med. 1979 Jan;2(1):63–65. doi: 10.1016/s0161-4630(79)80009-9. [DOI] [PubMed] [Google Scholar]
- Nayler W. G., Elz J. S. Reperfusion injury: laboratory artifact or clinical dilemma? Circulation. 1986 Aug;74(2):215–221. doi: 10.1161/01.cir.74.2.215. [DOI] [PubMed] [Google Scholar]
- Okamoto F., Allen B. S., Buckberg G. D., Bugyi H., Leaf J. Reperfusion conditions: importance of ensuring gentle versus sudden reperfusion during relief of coronary occlusion. J Thorac Cardiovasc Surg. 1986 Sep;92(3 Pt 2):613–620. [PubMed] [Google Scholar]
- Ratliff N. B., Young W. G., Jr, Hackel D. B., Mikat E., Wilson J. W. Pulmonary injury secondary to extracorporeal circulation. An ultrastructural study. J Thorac Cardiovasc Surg. 1973 Mar;65(3):425–432. [PubMed] [Google Scholar]
- Roberts W. C., Bulkley B. H., Morrow A. G. Pathologic anatomy of cardiac valve replacement: a study of 224 necropsy patients. Prog Cardiovasc Dis. 1973 May-Jun;15(6):539–587. doi: 10.1016/s0033-0620(73)80024-6. [DOI] [PubMed] [Google Scholar]
- Satoh K. Serum lipid peroxide in cerebrovascular disorders determined by a new colorimetric method. Clin Chim Acta. 1978 Nov 15;90(1):37–43. doi: 10.1016/0009-8981(78)90081-5. [DOI] [PubMed] [Google Scholar]
- Thomas C. E., Morehouse L. A., Aust S. D. Ferritin and superoxide-dependent lipid peroxidation. J Biol Chem. 1985 Mar 25;260(6):3275–3280. [PubMed] [Google Scholar]
- Volpini M., Giubbini R., Gei P., Cuccia C., Franzoni P., Riva S., Terzi A., Metra M., Bestagno M., Visioli O. Diagnosis of acute myocardial infarction by indium-111 antimyosin antibodies and correlation with the traditional techniques for the evaluation of extent and localization. Am J Cardiol. 1989 Jan 1;63(1):7–13. doi: 10.1016/0002-9149(89)91066-7. [DOI] [PubMed] [Google Scholar]
- Westaby S. Neutrophil protease enzymes and oxygen free radicals as mediators of pulmonary membrane damage. Prog Clin Biol Res. 1987;236A:75–86. [PubMed] [Google Scholar]
- Wickens D. G., Griffin J. F., Maher E. R., Curtis J. R., Dormandy T. L. The effect of systemic heparinisation and haemodialysis on plasma octadeca-9,11-dienoic acid (9,11-LA'). Free Radic Res Commun. 1987;3(1-5):99–106. doi: 10.3109/10715768709069775. [DOI] [PubMed] [Google Scholar]
- Yagi K. A simple fluorometric assay for lipoperoxide in blood plasma. Biochem Med. 1976 Apr;15(2):212–216. doi: 10.1016/0006-2944(76)90049-1. [DOI] [PubMed] [Google Scholar]
