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Tytuł pozycji:

Impaired myocardial t-PA release in patients with coronary artery disease

Tytuł :
Impaired myocardial t-PA release in patients with coronary artery disease
Index Terms :
Aged
Blood Pressure
Cardiac Pacing
Artificial/methods
Cardiac Surgical Procedures/methods
Catheterization
Swan-Ganz
Coronary Artery Disease/*metabolism
Coronary Thrombosis/prevention & control
Coronary Vessels/metabolism
Endothelium
Vascular/secretion
Female
Heart Rate
Humans
Male
Middle Aged
Myocardial Ischemia/*metabolism
Plasminogen Activator Inhibitor 1/*blood
Tissue Plasminogen Activator/*blood
Article in journal
info:eu-repo/semantics/article
text
Wydawca :
Umeå universitet, Anestesiologi och intensivvård Umeå universitet, Anestesiologi och intensivvård Umeå universitet, Anestesiologi och intensivvård Umeå universitet, Anestesiologi och intensivvård 2008
Dodane szczegóły :
Österlund, Barbro
Jern, Sverker
Jern, Christina
Seeman-Lodding, Helen
Östman, Margareta
Johansson, Göran
Biber, Björn
Typ dokumentu :
Zasób elektroniczny
URL :
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-31393">http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-31393
Acta Anaesthesiol Scand, 2008, 52:10, s. 1375-84
Dostępność :
Open access content. Open access content
info:eu-repo/semantics/openAccess
Pozostałe numery :
UPE oai:DiVA.org:umu-31393
urn:isbn:1399-6576 (Electronic)
808842486
Źródło wspomagające :
UPPSALA UNIV LIBR
From OAIster®, provided by the OCLC Cooperative.
Numer akcesji :
edsoai.ocn808842486
Zasób elektroniczny
AIMS: Myocardial ischemia remains a significant perioperative complication in coronary artery disease (CAD) patients. We hypothesized that noxious stimuli during major surgery are associated with an acute release of tissue-type plasminogen activator (t-PA) into the coronary circulation, and that this response is reduced by CAD. METHODS AND RESULTS: Two patient groups, with (n=14) and without (n=8) CAD, were studied during the initial phase of heart surgery. After retrograde great cardiac vein catheterizations during closed-chest conditions, coronary arterial-venous concentration gradients of t-PA and plasminogen activator inhibitor type-1 (PAI-1) were measured together with coronary blood flow measurements, allowing derivation of coronary net release rates. Pre-surgery atrial pacing, performed to evaluate the influence of increases in heart rate (+ 40 beats/min) and coronary blood flow (+ 80 ml/min), did not significantly alter coronary net release of t-PA or PAI-1 in either patient group. Sternotomy induced a prominent increase in coronary net release of both total and active t-PA in the non-CAD group. This response was considerably reduced in the CAD group. CONCLUSIONS: This study provides the first analysis of coronary t-PA release during major surgery and demonstrates a deficient local endothelial t-PA release in patients with CAD. This suggests a reduced local fibrinolytic capacity in CAD patients, which may explain the increased risk for coronary thrombosis in this patient group.
Osterlund, B Jern, S Jern, C Seeman-Lodding, H Ostman, M Johansson, G Biber, B Research Support, Non-U.S. Gov't England Acta anaesthesiologica Scandinavica Acta Anaesthesiol Scand. 2008 Nov;52(10):1375-84.

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