The role of obesity in the dynamics of renal function and Fas-mediated apoptosis after off-pump coronary artery bypass on a beating heart

Authors: Mirolyubova O.A. 1, Moseeva A.S. 1, Shonbin A.N. 2

Company: 1 Northern State Medical University of Ministry of Health of the Russian Federation, Troitskiy prospekt, 51, Arkhangelsk, 163001, Russian Federation
2 E.E. Volosevich First City Clinical Hospital of the Arkhangelsk region, ulitsa Suvorova, 1, Arkhangelsk, 163001, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2018-12-2-146-158

For citation: Mirolyubova O.A., Moseeva A.S., Shonbin A.N. The role of obesity in the dynamics of renal function and Fas-mediated apoptosis after off-pump coronary artery bypass on a beating heart. Creative Cardiology. 2018; 12 (2): 146–58 (in Russ.). DOI: 10.24022/1997-3187-2018-12-2-146-158

Received / Accepted:  August 23, 2017 / September 22, 2017

Keywords: Dynamic of kidney function heart failure with preserved ejection fraction Fas-mediated apoptosis off-pump coronary artery bypass

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Abstract

Objective. To assess the effect of obesity on activation of Fas-mediated apoptosis and glomerular kidney function in heart failure with preserved ejection fraction (HF-pEF) patients after off-pump coronary artery bypass (OPCAB).

Material and methods. 30 patients with HF-pEF survived OPCAB were included. Two groups were formed: with obesity and without obesity, which did not differ by sex and age. Soluble Fas receptor (sFas), sFas ligand (sFasL), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) were assessed by ELISA before the operation, in 48 h and 7 days after OPCAB. The changes of glomerular filtration rate (GFR) were determined in 7 days and 1 year after OPCAB.

Results. We revealed significant increase of sFasL in obese patients and lower values of antiapoptotic sFas in com- mon group in 48 h after OPCAB. There was different dynamics of GFR: increase in patients without obesity and reduction in obese in 1 year after OPCAB. GFR in patients without obesity was higher than in obese patients over year (111.0±22.2 vs 82.0±25.0 ml/min/1.73 m2; p=0.005). Such a difference was absent before surgery. Body mass index over 28 kg/m2 appeared to be GFR reduction predictor in 1 year after OPCAB.

Conclusion. In the early period after OPCAB apoptosis process activation with higher sFasL in 48 hours in obese patients and lower of antiapoptotic factor sFas levels were identified. Changes of GFR were associated with obesity: we revealed GFR reduction in obese patients and increased in those without obesity after OPCAB meaning the follow-up necessity in obese patients.

Acknowledgements. The study had no sponsorship
Conflict of interest. The authors declare no conflict of interest.

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About Authors

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery