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Myocardial Ischemia Induces SDF-1α Release in Cardiac Surgery Patients

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Abstract

In the present observational study, we measured serum levels of the chemokine stromal cell-derived factor-1α (SDF-1α) in 100 patients undergoing cardiac surgery with cardiopulmonary bypass at seven distinct time points including preoperative values, myocardial ischemia, reperfusion, and the postoperative course. Myocardial ischemia triggered a marked increase of SDF-1α serum levels whereas cardiac reperfusion had no significant influence. Perioperative SDF-1α serum levels were influenced by patients’ characteristics (e.g., age, gender, aspirin intake). In an explorative analysis, we observed an inverse association between SDF-1α serum levels and the incidence of organ dysfunction. In conclusion, time of myocardial ischemia was identified as the key stimulus for a significant upregulation of SDF-1α, indicating its role as a marker of myocardial injury. The inverse association between SDF-1α levels and organ dysfunction association encourages further studies to evaluate its organoprotective properties in cardiac surgery patients.

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Abbreviations

CABG:

Coronary artery bypass graft

CAD:

Coronary artery disease

CK-MB:

Creatine kinase isoenzyme MB

CPB:

Cardiopulmonary bypass

EPC:

Endothelial progenitor cells

FCS:

Fetal calf serum

HIF-1α:

Hypoxia-inducible factor 1α

HUVEC:

Human umbilical vein endothelial cells

I/R:

Ischemia/reperfusion

ICU:

Intensive care unit

MIF:

Macrophage migration inhibitory factor

PCT:

Procalcitonin

SAPS II:

Simplified acute physiology score II

SDF-1:

Stromal cell-derived factor 1

SIRS:

Systemic inflammatory response syndrome

WBC:

White blood cells

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Author notes

    Authors and Affiliations

    1. Department of Plastic Surgery, Hand Surgery, Burn Center, RWTH Aachen University, Aachen, Germany

      Bong-Sung Kim & Norbert Pallua

    2. Department of Intensive Care Medicine, University Hospital, RWTH Aachen, Aachen, Germany

      Denise Jacobs, Christoph Emontzpohl, Josefin Soppert, Mareike Jarchow, Luisa Averdunk, Gernot Marx & Christian Stoppe

    3. Department of Thoracic, Cardiac and Vascular Surgery, University Hospital, RWTH Aachen, Aachen, Germany

      Andreas Goetzenich, Lisa Schindler & Sandra Kraemer

    4. Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany

      Lisa Schindler & Jürgen Bernhagen

    5. Munich Cluster for Systems Neurology (SyNergy), Munich, Germany

      Jürgen Bernhagen

    6. German Cancer Research Center (DKFZ), Heidelberg, Germany

      Heinz-Peter Schlemmer & David Simons

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    1. Bong-Sung Kim
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    Corresponding authors

    Correspondence to David Simons or Christian Stoppe.

    Ethics declarations

    Human Study

    All patients provided written consent, the study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki, and the study was approved by the local ethics committee (Ethikkommission RWTH Aachen, EK 151/09).

    Animal Study

    No animal studies were carried out by the authors for this article.

    Sources of Funding

    Bong-Sung Kim is supported by “START”, a program for young scientists of the Medical Faculty at the RWTH Aachen University (Project number: 691346, START 2013–2) and the Research Fellowship Program of the German Research Foundation (Deutsche Forschungsgemeinschaft (DFG), GZ: KI 1973/1-1). Norbert Pallua is supported by DFG grant PA 1271/5-1. Jürgen Bernhagen is supported by DFG grants SFB1123/P03; SFB/TRR57-P07, and DFG BE1977/7-1, as well as by DFG within the framework of the Munich Cluster for Systems Neurology (EXC 1010 SyNergy). Christian Stoppe is supported by DFG grant DFG STO 1099/2-1.

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    The authors declare that they have no conflict of interest.

    Additional information

    Editor-in-Chief Jennifer L. Hall oversaw the review of this article

    All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation

    Bong-Sung Kim, Denise Jacobs, David Simons and Christian Stoppe contributed equally to this work.

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    Kim, BS., Jacobs, D., Emontzpohl, C. et al. Myocardial Ischemia Induces SDF-1α Release in Cardiac Surgery Patients. J. of Cardiovasc. Trans. Res. 9, 230–238 (2016). https://doi.org/10.1007/s12265-016-9689-x

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