[Endothelial parameters in blood plasma of patients suffering from ischaemic heart disease and undergoing surgery with extracorporeal circulation]

Abstract

Introduction: The participation of disturbances of the vascular endothelial function in the pathogenesis of post perfusion syndrome is controversial.

Aim: The aim of the study was the evaluation of the parameters of vascular endothelial injury in the blood plasma of patients undergoing surgery with extracorporeal circulation.

Methods: The study was performed in the group of 32 patients (M/F 23/9) with ischaemic heart disease, undergoing coronary artery bypass with extracorporeal circulation. In the blood plasma obtained in the couple of time points in the perioperative period the determinations were done as followed: the concentrations of von Willebrand factor antigen (vWf Ag), tissue plasminogen activator antigen (t-PA Ag), antigen of plasminogen activator inhibitor type 1 (PAI-1 Ag) and fibrinogen. The control group consisted of 29 healthy volunteers sex and age matched.

Results: In blood of patients suffering from ischaemic heart disease before surgery the increased concentrations of vWF Ag, t-PA Ag and fibrinogen were observed. The concentrations of t-PA Ag and vWf Ag hesitated in the perioperative period but always were significantly higher than observed in the control group.

Conclusions: (1) In the blood of patients suffering from the ischemic heart disease undergoing bypass surgery with an extracorporeal circulation the increased concentrations of t-PA Ag and vWf Ag were observed what is the evidence of stimulation/ damage of the vascular endothelium. (2) High levels of t-PA and vWf is seemed to be connected with injury of vessels during coronary artery bypass.