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Surgical stress induces acute coronary release of tissue-type plasminogen activator in the pig
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Anesthesiology and Intensive Care.
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Anesthesiology and Intensive Care.
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2000 (English)In: Acta Anaesthesiol Scand, Vol. 44, no 10, 1226-31 p.Article in journal (Refereed) Published
Abstract [en]

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.
Keyword [en]
Animals, Coronary Vessels/*secretion, Sternum/*surgery, Swine, Tissue Plasminogen Activator/blood/*secretion
Identifiers
URN: urn:nbn:se:umu:diva-31428ISBN: 0001-5172 (Print) OAI: oai:DiVA.org:umu-31428DiVA: diva2:293020
Note
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.Available from: 2010-02-10 Created: 2010-02-10 Last updated: 2015-09-15

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