Purpose: Obesity increases the development of cardiovascular risk factors: hypertonia, diabetes mellitus, endothel dysfunction. Our aim was to follow the response pattern of plasma adipokine and ghrelin levels to coronary artery bypass graft (CABG) surgery in patients with (on-pump) and without (off-pump) cardiopulmonary bypass (CPB).
Methods: 16 consecutive patients (age: 62±10 years, male: 10) with coronary artery disease (CAD) who underwent elective CABG surgery with CPB and intraoperative GIK infusion were selected for on-pump group and 19 CAD patients (age: 63±10 years, male: 16) were included in the off-pump group. Intraoperative samples were withdrawn simultaneously for peripheral vein (P) and coronary sinus (CS). Plasma adipokine concentrations were measured by ELISA, those of ghrelin by RIA kits. Blood samples were taken before, during and after surgery.
Results: In patients operated on-pump the surgical intervention resulted an early reduction in plasma levels of adiponectin (p<0.001) and resistin (p=0.002) followed by an increase to approach their initial values. Off-pump operation did not cause any changes in plasma resistin and adiponectin. During on-pump surgery the CPB induced a significant increase in the peripheral ghrelin levels (p=0.034), but not in coronary sinus (p=0.077). Ghrelin level remained mostly unaffected by off-pump surgery (p=0.267). In patients operated on-pump no discernible difference could be detected in plasma leptin levels between peripheral vein and coronary sinus (p=0.835).
Conclusions: Epicardial adipose tissue is unlikely to have major contribution to the development of CAD as adipokines are not elevated in the coronary sinus independent of the mode of intervention.