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stress hormons in cardiac surgery

Milad C El Hajj, Van K Ninh, Elia C El Hajj, Jessica M Bradley, Jason D Gardner
We have previously demonstrated the cardioprotective effects of ovarian hormones against adverse ventricular remodeling imposed by chronic volume overload. Here, we assess the estrogen receptor dependence of this cardioprotection. Four groups of female rats were studied: sham-operated (SHAM), volume overloaded (ACF), SHAM treated with estrogen receptor antagonist, ICI 182,780 (SHAM+ICI), and ACF treated with ICI. Cardiac function was assessed temporally using echocardiogram and tissue samples were collected at 5 days and 6 weeks post-surgery...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
S Pozzoli, M Simonini, E Messaggio, N Casamassima, E Bignami, L Zagato, C Lanzani, P Manunta
OBJECTIVE: Cardiovascular diseases remain the main cause of mortality and morbidity worldwide. The identification of subjects with increased risk of developing new cardiovascular events remains a priority in order to guide treatments and determine individual prognosis. Biomarkers are useful tools that are able to help physicians in decision-making. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure...
September 2016: Journal of Hypertension
Yan Li, Qing Yuan, Jie Huang, Yi Ping Li, Jian Pan, Xing Feng, Xue Guang Zhang, Jiang Huai Wang, Jian Wang
BACKGROUND: Surgical stress initiates a series of host hormone, metabolism and immune responses, which predominantly affect the homeostatic mechanism of patients with major surgery. B7-H3 is a co-stimulatory molecule and has been shown to participate in both adaptive and innate immune responses. In this study we evaluated the clinical significance of plasma B7-H3 levels in pediatric patients with different types of operation and degrees of surgical stress. METHODS: A total of 48 children received pediatric general and cardiac surgery were recruited into this study...
2016: BMC Pediatrics
Özge Korkmaz, Hakki Kaya, Osman Beton, Ali Zorlu, Sabahattin Göksel, Müslim Gül, İlker İnce, Öcal Berkan, Mehmet Birhan Yılmaz
OBJECTIVE: Coronary artery bypass graft surgery in one of the most effective and widely used methods employed in the treatment of ischemic heart disease, but many factors to various degrees are directly associated with perioperative and postoperative problems. In this study, we evaluated the relationship between preoperative eosinophil count and postoperative mortality in patients who underwent coronary artery bypass graft operation. METHODS: A total of 241 patients (157 males, 84 females) who underwent isolated on-pump coronary artery bypass graft operation between 2011 and 2013 in two centers were evaluated retrospectively...
2016: Heart Surgery Forum
Hongbin Sun, Liping Zhang, Xiuli Han, Zhongyu Wang, Lei Xu
OBJECTIVE: To compare the effects of thoracotomy and total thoracoscopic surgery on coronary artery fistulae complicated with ectasia. METHODS: Forty-six patients with coronary artery fistulae complicated with ectasia were randomly divided into a treatment group and a control group (n=23) which were given totally thoracoscopic surgery and thoracotomy respectively. Both groups were followed up. RESULTS: All patients survived the surgeries and were discharged from the hospital...
January 2016: Pakistan Journal of Medical Sciences Quarterly
Elizabeth W Duggan, Matthew A Klopman, Arnold J Berry, Guillermo Umpierrez
Hyperglycemia is a frequent manifestation of critical and surgical illness, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress (Umpierrez and Kitabchi, Curr Opin Endocrinol. 11:75-81, 2004; McCowen et al., Crit Care Clin. 17(1):107-24, 2001). The exact prevalence of hospital hyperglycemia is not known, but observational studies have reported a prevalence of hyperglycemia ranging from 32 to 60 % in community hospitals (Umpierrez et al., J Clin Endocrinol Metab...
March 2016: Current Diabetes Reports
L van Gulik, Sjgm Ahlers, M van Dijk, P Bruins, M E Meima, Y B de Rijke, H S Biemond-Moeniralam, D Tibboel, C A J Knibbe
The gold standard for quantification of pain is a person's self-report. However, we need objective parameters for pain measurement when intensive care patients, for example, are not able to report pain themselves. An increase in pain is currently thought to coincide with an increase in stress hormones. This observational study investigated whether procedure-related pain is associated with an increase of plasma cortisol, adrenaline, and noradrenaline. In 59 patients receiving intensive care after cardiac surgery, cortisol, adrenaline, and noradrenaline plasma levels were measured immediately before and immediately after patients were turned for washing, either combined with the removal of chest tubes or not...
January 2016: Anaesthesia and Intensive Care
Marco Simonini, Simona Pozzoli, Elena Bignami, Nunzia Casamassima, Elisabetta Messaggio, Chiara Lanzani, Elena Frati, Irene Maria Botticelli, Francesco Rotatori, Ottavio Alfieri, Alberto Zangrillo, Paolo Manunta
Cardiovascular diseases remain the main cause of mortality and morbidity worldwide; primary prevention is a priority for physicians. Biomarkers are useful tools able to identify high-risk individuals, guide treatments, and determine prognosis. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure. In a population of 845 patients undergoing elective cardiac surgery, we have investigated the relationships between EO and echocardiography parameters/plasmatic biomarker of cardiac function...
2015: BioMed Research International
Y Sun, H Ye, Y Xia, Y Li, X Yuan, X Wang
AIM: This study aims to explore the clinical efficacy of dexmedetomidine (DEX) in the diminution of fentanyl dosage in pediatric cardiac surgery based on some clinical and biochemical parameters. METHODS: Fifty pediatric patients (American Society of Anesthesiologists II), 1-6 years old, were randomly allocated into two groups: group F (control group), in which patients received normal saline and high dosage of fentanyl (30 μg/kg), and group D, in which patients were given DEX and low dosage of fentanyl (15 μg/kg)...
September 1, 2015: Minerva Pediatrica
Judith Hoefer, Eve Pierer, Barbara Rantner, Karl-Heinz Stadlbauer, Gustav Fraedrich, Josef Fritz, Axel Kleinsasser, Corinna Velik-Salchner
OBJECTIVE: Locoregional anesthesia is an effective method for evaluating cerebral function during carotid endarterectomy (CEA). Landmark-guided regional anesthesia (RA) is currently used for CEA and can provoke substantial perioperative hypertension. Ultrasound-guided RA (US-RA) is a new method for performing RA in CEA; however, the effect on sympathetic activity and blood pressure is uncertain. This study assessed early sympathetic activity during CEA in US-RA compared with general anesthesia (GA)...
July 2015: Journal of Vascular Surgery
Aymen N Naguib, Peter D Winch, Joseph D Tobias, Keith O Yeates, Yongjie Miao, Mark Galantowicz, Timothy M Hoffman
INTRODUCTION: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. MATERIALS AND METHODS: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1(st) year of life...
January 2015: Saudi Journal of Anaesthesia
Constantinos Pantos, Iordanis Mourouzis
Thyroid hormone (TH) appears to have a critical role in cardiac repair after injury beyond its role in development and metabolism homeostasis. This unique action is due to the fact that TH effect on the heart is shown to be differentiated depending on its administration on injured or healthy myocardium. Thus, TH can limit ischemia-reperfusion injury via a fine balance between pro-apoptotic and pro-survival signaling pathways. This response is thyroid hormone receptor (TRα1) dependent. Furthermore, an interaction between stress-induced growth kinase signaling and TRα1 is shown to occur and determine postischemic remodeling and cardiac recovery depending on the availability of TH...
May 2015: Heart Failure Reviews
Hirofumi Saiki, Seiko Kuwata, Clara Kurishima, Yoichi Iwamoto, Hirotaka Ishido, Satoshi Masutani, Hideaki Senzaki
Abnormal water metabolism is frequently observed after Fontan surgery. We hypothesized that patients' adrenal hormones show unique responses immediately after Fontan operation and that such a hormonal profile is related to postoperative hemodynamics and water imbalance. Twenty-eight patients who underwent a Fontan operation (n = 16) or a non-Fontan type operation (n = 12; controls) under cardiopulmonary bypass were studied. Postoperative urine cortisol and aldosterone levels were measured daily to minimize the influence of circadian rhythms and temporal hemodynamic variations...
November 15, 2014: American Journal of Cardiology
Jahan Porhomayon, Sergei Kolesnikov, Nader D Nader
The relationship and interactions between stress hormones and post-traumatic stress disorder (PTSD) are well established from both animal and human research studies. This interaction is especially important in the post-operative phase of cardiac surgery where the development of PTSD symptoms will result in increased morbidity and mortality and prolong length of stay for critically ill cardiac surgery patients. Cardiopulmonary bypass itself will independently result in massive inflammation response and release of stress hormones in the perioperative period...
2014: Journal of Cardiovascular and Thoracic Research
Nura Afshani, Simone Schülein, Bruce M Biccard, Jenny M Thomas
BACKGROUND: NP is a biomarker that has been used in the diagnosis, management, and prognostication of a number of cardiovascular disorders in the pediatric population. The physiological role of this hormone is to allow the myocardium to adapt to stress or strain imposed by a volume and/or pressure load. OBJECTIVE: The aim of this study was to determine the utility of preoperative and postoperative NP to predict outcome in pediatric patients undergoing cardiac surgery for structural congenital heart disease...
February 2015: Paediatric Anaesthesia
Marco Simonini, Chiara Lanzani, Elena Bignami, Nunzia Casamassima, Elena Frati, Roberta Meroni, Elisabetta Messaggio, Ottavio Alfieri, John Hamlyn, Simon C Body, C David Collard, Alberto Zangrillo, Paolo Manunta
BACKGROUND: Acute kidney injury (AKI) is an important complication of cardiac surgery. Recently, elevated levels of endogenous ouabain (EO), an adrenal stress hormone with haemodynamic and renal effects, have been associated with worse renal outcome after cardiac surgery. Our aim was to develop and evaluate a new risk model of AKI using simple preoperative clinical parameters and to investigate the utility of EO. METHODS: The primary outcome was AKI according to Acute Kidney Injury Network stage II or III...
September 2014: Nephrology, Dialysis, Transplantation
Antti Laurikka, Katriina Vuolteenaho, Vesa Toikkanen, Timo Rinne, Tiina Leppänen, Matti Tarkka, Jari Laurikka, Eeva Moilanen
OBJECTIVES: Adipocytokines are hormones regulating energy metabolism and appetite and according to recent reports also inflammatory responses including ischaemia-reperfusion injury. Based on experimental data, we hypothesized that the levels of adipocytokines adiponectin, adipsin, leptin and/or resistin would correlate with myocardial injury, inflammation and oxidative stress during cardiac surgery. METHODS: Thirty-two patients undergoing an elective on-pump coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB) were recruited into the study...
October 2014: European Journal of Cardio-thoracic Surgery
Joke Bradt, Cheryl Dileo, Noah Potvin
BACKGROUND: Individuals with coronary heart disease (CHD) often suffer from severe distress due to diagnosis, hospitalization, surgical procedures, uncertainty of outcome, fear of dying, doubts about progress in recovery, helplessness and loss of control. Such adverse effects put the cardiac patient at greater risk for complications, including sudden cardiac death. It is therefore of crucial importance that the care of people with CHD focuses on psychological as well as physiological needs...
2013: Cochrane Database of Systematic Reviews
Sheri S Crow, William C Oliver, Jamie A Kiefer, Melissa R Snyder, Joseph A Dearani, Zhuo Li, Harold M Burkhart
OBJECTIVES: We sought to evaluate whether there is variability in blood dexamethasone levels after a standard 1 mg/kg dose of dexamethasone administered before infant cardiopulmonary bypass. We hypothesized that postoperative dexamethasone drug levels are highly variable, and that the infant stress response is related inversely to the amount of dexamethasone measured in the blood. METHODS: Thirty-two infants (age, ≤365 days) received 1 mg/kg of dexamethasone before cardiopulmonary bypass (CPB) initiation...
January 2014: Journal of Thoracic and Cardiovascular Surgery
Youhua Zhang, Eduard I Dedkov, Diana Teplitsky, Nathan Y Weltman, Christine J Pol, Viswanathan Rajagopalan, Bianca Lee, A Martin Gerdes
BACKGROUND: Evidence indicates that cardiac hypothyroidism may contribute to heart failure progression. It is also known that heart failure is associated with an increased risk of atrial fibrillation (AF). Although it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats...
October 2013: Circulation. Arrhythmia and Electrophysiology
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