Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598861
Oral Presentations
Monday, February 13th, 2017
DGTHG: Basic Science: Congenital Heart Disease
Georg Thieme Verlag KG Stuttgart · New York

Cardiopulmonary Bypass Reduces Myocardial Oxidative Stress, Inflammation and Increases C-Kit+CD45- Cell Population in Newborns

J. Petersen
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
A. Kazakov
3   Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany
,
M. Böhm
3   Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany
,
H. Reichenspurner
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
H.J. Schäfers
4   Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
,
U. Laufs
3   Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany
,
H. Abdul-Khaliq
2   Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

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Objective: The aim of this study was to characterize the influence of cardiopulmonary bypass (CPB) on myocardial remodeling, oxidative stress, cell turnover, inflammatory infiltration and number of resident cardiac stem cells (RCSC) in newborns and children.

Methods: Biopsies from the right atrium were taken before and after CPB from 4 newborns (5–11 days old) and 7 children (8 months-16 years old). Further tissue was taken from the left ventricle (LV) of 3 children. Intermittent antegrade warm blood cardioplegia (Calafiore) was used in all cases. Immunostainings on 10 µm heart tissue frozen sections were performed to detect cardiomyocytes, c-kit+ cells, leukocytes (CD45+cells), Ki67+ cycling cells. The percentage of 8-hydroxy-guanosine (8-dOHG)+cardiomyocytes and non-cardiomyocytes ((8-dOHG)+-index) were determined to quantify oxidative stress.

Results: Resident cardiac stem cells were identified as c-kit+CD45- cell population. Δ c-kit+CD45-cells was increased in newborns (2.2 ± 1.9/ mm2) and decreased in children -1.5 ± 0.7/ mm2, p < 0.01. The (8-dOHG)+-index was reduced by 43% in newborns and by 20% in children. The number of cardiomyocytes per mm2 detected by immunostaining for α-sarcomeric actin was not changed by CPB both in the newborns (7,906 ± 764/mm2 vs. 6,865 ± 1,175/ mm2, n.s.) and in the children (8,732 ± 1,168/mm2 vs. 9,600 ± 1,016/mm2, n.s.). The percentage of Ki67+ cycling cardiomyocytes and non-cardiomyocytes was not changed by CPB in both groups. The numbers of apoptotic cardiomyocytes and non-cardiomyocytes were not changed after CPB in both groups.

Cardiopulmonary bypass significantly decreased the leucocyte infiltration (CD 45%) in newborns to 40 ± 8%, p < 0.05, but not in in children. Infiltration with eosinophils (eosinophils /CD45%) was completely abolished in the myocardium of newborns p < 0.05 and reduced to 22 ± 8% in children after CPB, n.s.

Conclusion: Immediate response and remodeling of the myocardium to corrective surgery by means of the CPB is significantly different between the newborns and older infants and children. The clinical value of such observation should be further assessed in larger cohorts of patients.