4.1 Review

Microvascular dysfunction in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass

Journal

CURRENT OPINION IN CARDIOLOGY
Volume 31, Issue 6, Pages 618-624

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HCO.0000000000000340

Keywords

cardiac surgery; cardioplegia; cardiopulmonary bypass; diabetes mellitus; microvascular dysfunction

Funding

  1. NIH [2 R01 HL046716-22A1, 1RO1HL128831-01A1, 1R01 HL127072-01A1, NIH-5P20 GM1P20GM103652-Pilot Project]
  2. American Heart Association [15GRNT25710105]
  3. Rhode Island Foundation [RIF-20123834]

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Purpose of reviewThe purpose of the current review is to describe the changes of microvascular function in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass (CPB) and cardiac surgery.Recent findingsCardiac surgery, especially that involving cardioplegia and CPB, is associated with significant changes in vascular reactivity of coronary/peripheral microcirculation, vascular permeability, gene/protein expression, and programmed cell death, as well as with increased morbidity and mortality after surgical procedures. In particular, these changes are more profound in patients with poorly controlled diabetes.SummaryBecause alterations in vasomotor regulation are critical aspects of mortality and morbidity of cardioplegia/CPB, a better understanding of diabetic regulation of microvascular function may lead to improved postoperative outcomes of patients with diabetes after cardioplegia/CPB and cardiac surgery.

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