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Observational Study
. 2015 Mar;43(3):250-4.
doi: 10.1097/SHK.0000000000000306.

Pyruvate Dehydrogenase Activity and Quantity Decreases After Coronary Artery Bypass Grafting: a Prospective Observational Study

Lars W Andersen  1 , Xiaowen Liu, Teng J Peng, Tyler A Giberson, Kamal R Khabbaz, Michael W Donnino
Affiliations
Observational Study

Pyruvate Dehydrogenase Activity and Quantity Decreases After Coronary Artery Bypass Grafting: a Prospective Observational Study

Lars W Andersen et al. Shock. 2015 Mar.

Abstract

Introduction: Pyruvate dehydrogenase (PDH) is a key gatekeeper enzyme in aerobic metabolism. The main purpose of this study was to determine if PDH activity is affected by major stress in the form of coronary artery bypass grafting (CABG), which has previously been used as a model of critical illness.

Methods: We conducted a prospective, observational study of patients undergoing CABG at an urban, tertiary care hospital. We included adult patients undergoing CABG with or without concomitant valve surgery. Measurements of PDH activity and quantity and thiamine were obtained prior to surgery, at the completion of surgery, and 6 h after surgery.

Results: Fourteen patients were enrolled (aged 67 ± 10 years, 21% female). Study subjects had a mean 41.7% (SD, 27.7%) reduction in PDH activity after surgery and a mean 32.0% (SD, 31.4%) reduction 6h after surgery (P < 0.001). Eight patients were thiamine deficient (≤ 7 nmol/L) after surgery compared with none prior to surgery (P = 0.002). Thiamine level was significantly associated with PDH quantity at all time points (P = 0.01). Postsurgery lactate levels were inversely correlated with postsurgery thiamine levels (r = -0.58 and P = 0.04).

Conclusion: The stress of major surgery causes decreased PDH activity and quantity and depletion of thiamine levels.

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Figures

Figure 1
Figure 1
The role of PDH and thiamine in aerobic metabolism. Reprinted/adapted from Andersen et al.(35) with permission from Elsevier. ATP = Adenosine triphosphate; CoA = Coenzyme A; PDH = Pyruvate dehydrogenase
Figure 2
Figure 2
Relative PDH activity (A), quantity (B) and specific activity (C) before and after the surgery. The graphs represent mean with the error bar indicating one standard deviation. There was a significant change in all three measurements over time (p < 0.001). . PDH = Pyruvate dehydrogenase
Figure 3
Figure 3
Thiamine levels before and after the surgery. The box plots represent minimum, 1st quartile, median, 3rd quartile and maximum. There was a significant change in thiamine over time (p < 0.001).
See this image and copyright information in PMC

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