Alterations in plasma soluble vascular endothelial growth factor receptor-1 (sFlt-1) concentrations during coronary artery bypass graft surgery: relationships with post-operative complications.
BACKGROUND
Plasma concentrations of sFlt-1, the soluble form of the vascular endothelial growth factor receptor (VEGF), markedly increase during coronary artery bypass graft (CABG) surgery with extracorporeal circulation (ECC). We investigated if plasma sFlt-1 values might be related to the occurrence of surgical complications after CABG.


METHODS
Plasma samples were collected from the radial artery catheter before vascular cannulation and after opening the chest, at the end of ECC just before clamp release, after cross release, after weaning from ECC, at the 6th and 24th post-operative hour. Thirty one patients were investigated. The presence of cardiovascular, haematological and respiratory dysfunctions was prospectively assessed. Plasma sFlt-1 levels were measured with commercially ELISA kits.


RESULTS
Among the 31 investigated patients, 15 had uneventful surgery. Patients with and without complications had similar pre-operative plasma sFlt-1 levels. Lowered plasma sFlt-1 levels were observed at the end of ECC in patients with haematological (p = 0.001, ANOVA) or cardiovascular (p = 0.006) impairments, but not with respiratory ones (p = 0.053), as compared to patients with uneventful surgery.


CONCLUSIONS
These results identify an association between specific post-CABG complication and the lower release of sFlt-1 during ECC. sFlt-1-induced VEGF neutralisation might, thus, be beneficial to reduce the development of post-operative adverse effects after CABG.
Denizot
Yves
Y
UMR CNRS 6101, Centre National de la Recherche Scientifique, Université de Limoges, France. yves.denizot@unilim.fr
Leguyader
Alexandre
A
Cornu
Elisabeth
E
Laskar
Marc
M
Orsel
Isabelle
I
Vincent
Christelle
C
Nathan
Nathalie
N
D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000097:blood* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1