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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

Full text:  

 

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.

References

  1. Ter Maaten J.M., Damman K., Verhaar K.M., Paulus W.J., Duncker D.J., Cheng C. et al. Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation. Eur. J. Heart Fail. 2016; 18: 588–98. DOI: 10.1002/ejhf.497

  2. Brunner H., Cockcroft J.R., Deanfield J., Do- nald A., Ferrannini E., Halcox J. et al. Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. Endo- thelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J. Hypertens. 2005; 23: 233–46

  3. Campbell D.J., Somaratne J.B., Prior D.L., Yii M., Kenny J.F., Newcomb A.E., Kelly D.J., Black M.J. Obesity is associated with lower coronary microvascular density. PLoS One. 2013; 8 (11): e81798. DOI: 10.1371/journal.pone.0081798

  4. Hoenig M.R., Bianchi C., Rosenzweig A., Sellke F.W. The cardiac microvasculature in hypertension, cardiac hypertrophy and diastolic heart failure. Curr. Vasc. Pharmacol. 2008; 6: 292–300. DOI: 10.2174/157016108785909779

  5. Gottlieb R.A., Burleson K.O., Kloner R.A. et al. Reperfusion injury induces apoptosis in rabbit cardiomyocytes. J. Clin. Invest. 1994; 94 (4): 1621–8. DOI: 10.1172/JCI117504

  6. Ost’adal B., Kolar F. Cardiac ischemia: from injury to protection. Boston; 1999

  7. Engler R.L., Gottlieb R.A., Burleson K.O., Babior B.M. Myocyte cell death by apoptosis during reperfusion. Circulation. 1993; 88 (S1): 1–5

  8. Savunen T., Kentala E., Perttila J. et al. Apoptosis and heat-shock proteins as indicator of a myocardial ischemiareperfusion injury. An experimental study with pigs. The 46th Annual Meeting of the Scandinavian Association for Thoracic Surgery. Abstract 119. Troudheim, Norway; 1999

  9. Nishigaki K., Minatoguchi S., Seishima M. et al. Plasma Fas-ligand, an inducer of apoptosis, and plasma Fas, an inhibitor of apoptosis, in patients with chronic congestive heart failure. J. Am. Coll. Cardiol. 1997; 29: 1214–20

  10. James T.N. Morphologic characteristics and functional significance of focal fibromuscular dysplasia of small coronary arteries. Am. J. Cardiol. 1990; 65: 12G–22G

  11. Shah S.J., Katz D.H., Selvaraj S., Burke M.A., Yancy C.W., Gheorghiade M. et al. Phenomapping for novel classification of heart failure with preserved ejection fraction. Circulation. 2015; 131: 269–79. DOI: 10.1161/CIRCULATIONAHA.114.010637

  12. Ponikowski P., Voors A., Anker S., Bueno H., Cleland J., Coats A. et al. Рекомендации ESC ПО диагностике и лечению острой и хронической сердечной недостаточности 2016. Российский кардиологический журнал. 2017; 1: 7–81. DOI: 10.15829/1560-4071-2017-1-7-81

  13. Mirolyubova O.A., Alekseeva M.A., Yakovleva A.S., Shonbin A.N. Acute kidney injury after coronary artery bypass grafting on the beating heart: predicting outcomes. Nephrol. Dial. 2014; 16 (3): 350–8 (in Russ.)

  14. Bellomo R., Ronco C., Kellum J.A., Mehta R.L., Palevsky P. Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit. Care. 2004; 8: R204–12. DOI: 10.1186/CC2872

  15. Komarova O.V., Kucherenko A.G., Smirnov I.E., Tsygin A.N. Role of apoptosis in the progression of chronic kidney disease progression in childhood. Nephr. Dial. 2013; 15 (2): 135–9 (in Russ.)

  16. Blanco-Colio L.M., Martin-Ventura J.L., Sol J.M. et al. Decreased circulating Fas ligand in patients with familial combined hyperlipidemia or carotid atherosclerosis. J. Am. Coll. Card. 2011; 43: 1188–94. DOI: 10.1016/j.jacc.2003.10.046

  17. Kayukov I.G., Smirnov A.V., Emanuel’ V.L. Cystatin C in carrent medicine. Nephrology. 2012; 16 (1): 22–39 (in Russ.)

  18. Mrikaev D.V. Left ventricular diastolic dysfunction in patients with heart failure. Creative Cardiology. 2017; 11 (2): 145–58. DOI: 10.24022/1997-3187- 2017-11-2-145-158 (in Russ.)

  19. Berezikova E.N., Pustovetova M.G., Shilov S.N., Efremov A.V., Safronov I.D., Samsonova E.N. et al. Effect of apoptosis during chronic heart failure. Circ. Pathol. Cardiosurg. 2012; 4: 55–8 (in Russ.)

  20. Musiał K., Zwolińska D. Matrix metalloproteinas- es and soluble Fas/FasL system as novel regulators of apoptosis in children and young adults on chronic dialysis. Apoptosis. 2011; 16: 653–9. DOI: 10.1007/s10495-011-0604-2

  21. Shroyer A.L., Hattler B., Wagner T.H., Collins J.F., Baltz J.H., Jacquelyn R.N. et al. Five-year out- comes after on-pump and off-pump coronaryartery bypass. N. Engl. J. Med. 2017; 377: 623–32. DOI: 10.1056/NEJMoa1614341

  22. Shumkov K.V. Outcomes and results of on- and off- pump coronary artery bypass grafting / Advantages and disadvantages of methods according to ran- domized trail data. Creative Cardiology. 2018; 12 (1): 22–30. DOI: 10.24022/1997-3187-2018-12-1-22-30 (in Russ.)

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


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