Surgical stress induces acute coronary release of tissue-type plasminogen activator in the pig
2000 (English)In: Acta Anaesthesiol Scand, Vol. 44, no 10, 1226-31 p.Article in journal (Refereed) Published
BACKGROUND: Tissue-type plasminogen activator (t-PA) is an endothelium derived key enzyme in the initiation of endogenous fibrinolysis. Acute regulated release of active t-PA occurs within minutes in response to threatening thrombotic vessel occlusion. The aim of this study was to investigate the impact of surgical stimulation on the kinetics of t-PA release in the coronary vascular bed in the pig. METHODS: In anaesthetised pigs (n=16), arterio-venous concentration gradients of t-PA, and plasma flows (retrograde thermodilution) were obtained across the coronary vascular bed before (control) and at 1, 3, 5 and 10 min after sternotomy. RESULTS: At control, no significant coronary net flux (release or uptake) of t-PA was observed, while sternotomy induced a rapid net release of total t-PA (132.6 ng x min(-1)), with an associated increase in active t-PA (93.6 ng x min(-1)). This response, evident already after 1 min, showed a peak at 5 min and returned towards baseline levels within 10 min. No concurrent alterations in aortic levels of active t-PA were found and haemodynamic variables were unaltered. CONCLUSION: The rapidly increasing and transient net coronary release of t-PA after sternotomy suggests that the endothelium actively promotes local endogenous fibrinolysis during surgery. Such events could reflect a dynamic responsiveness to protect the coronary circulation during stress.
Place, publisher, year, edition, pages
2000. Vol. 44, no 10, 1226-31 p.
Animals, Coronary Vessels/*secretion, Sternum/*surgery, Swine, Tissue Plasminogen Activator/blood/*secretion
IdentifiersURN: urn:nbn:se:umu:diva-31428ISBN: 0001-5172 (Print)OAI: oai:DiVA.org:umu-31428DiVA: diva2:293020
Osterlund, B Holmgren, A Haggmark, S Jern, C Johansson, G Seeman-Lodding, H Biber, B Research Support, Non-U.S. Gov't Denmark Acta anaesthesiologica Scandinavica Acta Anaesthesiol Scand. 2000 Nov;44(10):1226-31.2010-02-102010-02-102015-09-15