title: Altered protein metabolism following coronary artery bypass graft (CABG) surgery.
abstract: The aim of the present study was to investigate the acute effect of CABG (coronary artery bypass graft) surgery on the rates of synthesis of muscle protein, the positive acute-phase protein fibrinogen and the negative acute-phase protein albumin. Synthesis rates of muscle protein, fibrinogen and albumin were measured simultaneously before and 4 h after the end of surgery from the incorporation of L-[(2)H(5)]phenylalanine (given at 43 mg/kg of body weight) in 12 patients undergoing CABG surgery. Surgery was performed either with the use of extracorporeal circulation with cardiopulmonary bypass (on-pump; n=5) or with the beating heart procedure without cardiopulmonary bypass (off-pump; n=7). Post-surgical muscle protein fractional synthesis rates were decreased by 36+/-6.5% compared with pre-surgical values (1.59+/-0.10 compared with 0.97+/-0.08%/day respectively; P<0.001). In contrast, the synthesis rates of both fibrinogen (36+/-4 compared with 100+/-11 mg.day(-1).kg(-1) of body weight; P<0.0001) and albumin (123+/-12 compared with 178+/-19 mg.day(-1).kg(-1) of body weight; P<0.001) were both significantly increased after surgery. No significant differences were found between surgery performed with or without cardiopulmonary bypass. In conclusion, the results demonstrate that CABG surgery has a profound effect on protein metabolism, with a differential response of protein synthesis in muscle and liver.
authors.affiliation: Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY 11794-8191, USA. Giuseppe.Caso@stonybrook.edu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caso
authors.forename: James A
authors.initials: JA
authors.lastname: Vosswinkel
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Garlick
authors.forename: Mohamed K
authors.initials: MK
authors.lastname: Barry
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Bilfinger
authors.forename: Margaret A
authors.initials: MA
authors.lastname: McNurlan
mesh_terms: D000418:Albumins / Q000032:analysis / Q000096:biosynthesis; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000096:biosynthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000096:biosynthesis; D009132:Muscles / Q000378:metabolism; D010649:Phenylalanine / Q000378:metabolism; D010953:Plasma Volume; D011184:Postoperative Period; D014176:Protein Biosynthesis
chemical_list: D000418:Albumins; D009124:Muscle Proteins; D010649:Phenylalanine; D005340:Fibrinogen