title: GDF-15 is increased during early reperfusion following aortic valve replacement.
abstract: OBJECTIVE
  To examine the circulating levels of Growth differentiation factor 15 (GDF-15) and Interleukin 18 (IL-18) in relation to ischemia and early reperfusion, and cardioplegia type during isolated aortic valve replacement (AVR).
  
  
  METHODS
  Thirty consecutive patients operated for aortic stenosis with AVR at Oslo University Hospital, Ullevål, were included in the study. The patients were randomized into two groups, receiving either cold blood or crystalloid cardioplegia. Samples from both the radial artery and coronary sinus were analyzed before cardiac ischemia, and after 5 and 20 minutes of reperfusion.
  
  
  RESULTS
  Radial artery and coronary sinus plasma GDF-15 were significantly elevated after 5 and 20 minutes of reperfusion in both cardioplegia groups. In the total group of thirty patients, this represented an increase of 31% and 55% in the radial artery and an increase of 27% and 40% in the coronary sinus after 5 and 20 minutes of reperfusion respectively. IL-18 increased after 20 minutes of reperfusion in the crystalloid cardioplegia group only. No veno-arterial differences were detected during reperfusion.
  
  
  CONCLUSIONS
  Plasma levels of GDF-15 were significantly elevated after 5 and 20 minutes of myocardial reperfusion during AVR. Plasma levels of IL-18 were elevated after 20 minutes, but only when using crystalloid cardioplegia.
authors.affiliation: Department of Cardiothoracic Surgery and Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Peter
authors.initials: P
authors.lastname: Majak
authors.forename: Bjørn
authors.initials: B
authors.lastname: Braathen
authors.forename: Johannes L
authors.initials: JL
authors.lastname: Bjørnstad
authors.forename: Theis
authors.initials: T
authors.lastname: Tønnessen
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents; D054326:Coronary Sinus; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000096:biosynthesis* / Q000187:drug effects; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D019410:Interleukin-16 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000009:adverse effects*; D017680:Potassium Compounds; D017534:Radial Artery; D013223:Statistics as Topic; D013997:Time Factors
chemical_list: D002316:Cardiotonic Agents; D055436:Growth Differentiation Factor 15; D019410:Interleukin-16; D017680:Potassium Compounds; C018369:potassium cardioplegic solution