Cardiopulmonary bypass reduces atrial Na+-K+-ATPase expression in children.
Cardiopulmonary bypass (CPB) may induce serious side effects, potentially leading to myocardial failure. The Na(+)-K(+)-ATPase is a key component for myocardial function. Due to its developmental regulation, results from adult studies cannot be adopted to the situation in childhood. Right atrial myocardium from patients with left-to-right shunts at atrial level (VO, n=8) and those without (NO, n=8) was excised during heart surgery before and after CPB. Na(+)-K(+)-ATPase isoforms ATP1A1 (p=0.008) and ATP1A3 (p=0.038) decreased during CPB, which decrease was restricted to the VO group. This study highlights the importance of the underlying heart defect for susceptibility to the effects of CPB, showing a reduced Na(+)-K(+)-ATPase mRNA expression only in patients with left-to-right shunts on the atrial level. This seemed to be an early molecular event, as apart from one, none of the patients showed heart failure before or after surgery.
Pavlovic
Mladen
M
Division of Pediatric Cardiology, Department of Pediatrics, University Hospital, 3010 Berne, Switzerland. mladen.pavlovic@insel.ch
Schaller
André
A
Ammann
Roland A
RA
Sanz
Javier
J
Pfammatter
Jean-Pierre
JP
Carrel
Thierry
T
Berdat
Pascal
P
Gallati
Sabina
S
D000293:Adolescent; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D017931:DNA Primers; D005260:Female; D006325:Heart Atria / Q000201:enzymology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012333:RNA, Messenger / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000254:Sodium-Potassium-Exchanging ATPase / Q000235:genetics / Q000378:metabolism*
D017931:DNA Primers; D012333:RNA, Messenger; D000254:Sodium-Potassium-Exchanging ATPase