Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass
Background: Cell-derived microparticles (MPs) as membrane vesicles are procoagulant. They play a role in surgical hemostasis. In this study, the correlations between the circulating level of cell-derived MPs and surgical variables in heart valve surgery were investigated. Methods: The present pr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2022-07-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/1615 |
| _version_ | 1797986034544279552 |
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| author | Mehrnaz Abdolalian Elham Khalaf-Adeli Fatemeh Yari Saeid Hosseini Hooman Bakhshandeh |
| author_facet | Mehrnaz Abdolalian Elham Khalaf-Adeli Fatemeh Yari Saeid Hosseini Hooman Bakhshandeh |
| author_sort | Mehrnaz Abdolalian |
| collection | DOAJ |
| description |
Background: Cell-derived microparticles (MPs) as membrane vesicles are procoagulant. They play a role in surgical hemostasis. In this study, the correlations between the circulating level of cell-derived MPs and surgical variables in heart valve surgery were investigated.
Methods: The present prospective case-series study was conducted in Rajaie Cardiovascular Medical and Research Center from January through March 2021. Forty patients undergoing heart valve surgery with cardiopulmonary bypass (CPB) were enrolled. Before the induction of anesthesia and 30 minutes after the administration of protamine sulfate, venous blood samples were collected. After MP isolation, the concentration of MPs was determined via the Bradford method. Flow cytometry analysis was performed to determine the MP count and phenotype. Intraoperative variables and postoperative routine coagulation tests were defined as surgical variables. Postoperative coagulopathy was defined as an activated partial thromboplastin time (aPTT) ≥48 seconds or an international normalized ratio (INR) >1.5.
Results: The total concentration of MPs and the MP count increased significantly after surgery compared with before surgery. The postoperative concentration of MPs was positively correlated with the CPB time (P=0.030, ρ=0.40). The preoperative concentration of MPs was significantly lower in patients with higher postoperative aPTT and INR (P=0.003, Ρ= −0.50 and P=0.020, Ρ= −0.40, respectively). In multivariate logistic regression analysis, the preoperative MP concentration (OR, 1.00; 95% CI, 1.00 to 1.01; P=0.017) was considered a risk factor for postoperative coagulopathy.
Conclusion: The levels of MPs, especially platelet-derived MPs, rose after surgery, in correlation with the CPB time. Given the role of MPs in the induction of coagulation and inflammation, they can be considered therapeutic goals for preventing postoperative complications. In addition, the preoperative levels of MPs are a risk factor for predicting the occurrence of postoperative coagulopathy in heart valve surgery.
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| first_indexed | 2024-04-11T07:27:56Z |
| format | Article |
| id | doaj.art-aa7f6a332a6f4e7c98f4305760bdd96b |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-04-11T07:27:56Z |
| publishDate | 2022-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-aa7f6a332a6f4e7c98f4305760bdd96b2022-12-22T04:37:01ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712022-07-0117310.18502/jthc.v17i3.10846Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary BypassMehrnaz Abdolalian0Elham Khalaf-Adeli1Fatemeh Yari2Saeid Hosseini3Hooman Bakhshandeh4Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Background: Cell-derived microparticles (MPs) as membrane vesicles are procoagulant. They play a role in surgical hemostasis. In this study, the correlations between the circulating level of cell-derived MPs and surgical variables in heart valve surgery were investigated. Methods: The present prospective case-series study was conducted in Rajaie Cardiovascular Medical and Research Center from January through March 2021. Forty patients undergoing heart valve surgery with cardiopulmonary bypass (CPB) were enrolled. Before the induction of anesthesia and 30 minutes after the administration of protamine sulfate, venous blood samples were collected. After MP isolation, the concentration of MPs was determined via the Bradford method. Flow cytometry analysis was performed to determine the MP count and phenotype. Intraoperative variables and postoperative routine coagulation tests were defined as surgical variables. Postoperative coagulopathy was defined as an activated partial thromboplastin time (aPTT) ≥48 seconds or an international normalized ratio (INR) >1.5. Results: The total concentration of MPs and the MP count increased significantly after surgery compared with before surgery. The postoperative concentration of MPs was positively correlated with the CPB time (P=0.030, ρ=0.40). The preoperative concentration of MPs was significantly lower in patients with higher postoperative aPTT and INR (P=0.003, Ρ= −0.50 and P=0.020, Ρ= −0.40, respectively). In multivariate logistic regression analysis, the preoperative MP concentration (OR, 1.00; 95% CI, 1.00 to 1.01; P=0.017) was considered a risk factor for postoperative coagulopathy. Conclusion: The levels of MPs, especially platelet-derived MPs, rose after surgery, in correlation with the CPB time. Given the role of MPs in the induction of coagulation and inflammation, they can be considered therapeutic goals for preventing postoperative complications. In addition, the preoperative levels of MPs are a risk factor for predicting the occurrence of postoperative coagulopathy in heart valve surgery. https://jthc.tums.ac.ir/index.php/jthc/article/view/1615Cell-derived microparticlesHeart valve diseaseCardiac surgical procedure |
| spellingShingle | Mehrnaz Abdolalian Elham Khalaf-Adeli Fatemeh Yari Saeid Hosseini Hooman Bakhshandeh Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass Journal of Tehran University Heart Center Cell-derived microparticles Heart valve disease Cardiac surgical procedure |
| title | Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass |
| title_full | Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass |
| title_fullStr | Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass |
| title_full_unstemmed | Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass |
| title_short | Correlations Between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass |
| title_sort | correlations between the circulating level of cell derived microparticles and surgical variables in heart valve surgery with cardiopulmonary bypass |
| topic | Cell-derived microparticles Heart valve disease Cardiac surgical procedure |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/1615 |
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