TUMOR NECROSIS FACTOR-" AND TROPONIN I RELEASE IN PORCINE CARDIAC LYMPH AND CORONARY SINUS BLOOD BEFORE AND AFTER CARDIOPULMONARY BYPASS

Abstract

To assess the concentrations of cardiac troponin I (cTnI) and tumor necrosis factor-"(TNF") in cardiac lymph compared with coronary sinus (CS) blood and to measure cardiaclymph flow before and after cardiopulmonary bypass (CPB). In 21 pigs, the main cardiac lymphtrunk was cannulated before institution of standardized CPB. Lymph flow, cTnI and TNF" incardiac lymph and CS blood were measured before and after CPB for 6 hours. Before CPB, cTnIconcentration was 215 ± 36 ng/ml in cardiac lymph and 0.5 ± 0.1 ng/ml in CS blood,respectively. After aortic declamping a significant elevation of cTnI values was measured incardiac lymph and CS blood. cTnI concentration in cardiac lymph and CS blood peaked 6 hrsafter CPB (10,556 ± 4,735 vs. 22.2 ± 3.7 ng/ml, p<0.01). TNF" concentration at baseline was23.2 ± 5.6 pg/ml in lymph and 18.7 ± 9.5 pg/ml in CS blood, and there was no significant releaseof TNF" up to the end of the experiment. Baseline cardiac lymph flow was 3.07 ± 0.35 ml/h anddeclined after aortic clamping (0.72 ± 0.16 ml/h; p<0.01) and peaked one hour after CPB (5.66± 0.97 ml/h; p<0.01).In conclusion, very high cTnI concentrations in cardiac lymph suggest serious perioperativemyocardial damage after CPB with cardiologia, which is underestimated by cTnI release into thebloodstream. In our study, the myocardium was not a major source of TNF" release.