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Early gene expression profiles during intraoperative myocardial ischemia-reperfusion in cardiac surgery

2007; Elsevier BV; Volume: 134; Issue: 1 Linguagem: Inglês

10.1016/j.jtcvs.2007.01.025

1097-685X

Sara Arab, Igor E. Konstantinov, Cathy Boscarino, Eva Cukerman, Alessandro Mori, Jia Li, Peter P. Liu, Andrew N. Redington, John G. Coles,

Mechanical Circulatory Support Devices

The effects of cold cardioplegic arrest and reperfusion on human ventricular gene expression are unknown. We tested the hypothesis that intraoperative ischemia-reperfusion under conditions of blood cardioplegic arrest would induce a unique myocardial genomic profile indicative of a cardioprotective response.Right ventricular samples were serially acquired during surgical repair of ventricular septal defect.Expression profiling revealed 3 patterns of gene expression: (1) increased expression above control levels within 1 hour of cardioplegic arrest, with further amplification during early reperfusion; (2) increased expression limited to the reperfusion phase; and (3) reduced expression during reperfusion. Functional annotation and network mapping of differentially expressed genes indicated activation of multiple signaling pathways regulated by phosphatidylinositide 3'-OH kinase convergent on cellular growth and reparative programs. Also observed was increased expression of genes regulating hemoglobin synthesis, suggesting a novel cardioprotective pathway evoked during ischemia-reperfusion.Reversible myocardial ischemia-reperfusion during cardiac surgery is associated with an immediate genomic response that predicts a net cardioprotective phenotype.