Expressão de proteínas de choque térmico e avaliação de marcadores de perfusão tecidual e escore de risco euroscore como preditores de morbimortalidade em pacientes com função ventricular normal submetidos a cirurgia de revascularização do miocárdio com circulação extracorpórea

Abstract

Coronary artery bypass grafting with cardiopulmonary bypass (CABG) has allowed over the last decades, increased survival, improvement in symptoms and quality of life of patients with coronary disease, currently considered one of the leading causes of mortality in developed countries. The use of this surgical method, however, is assigned a complex organic systemic inflammatory response, which greatly contributes to various adverse effects in the postoperative period. In order to evaluate the expression of heat shock proteins (HSPs), associated with the tissue hypo perfusion markers, such as blood lactate, and risk score EuroSCORE as mortality predictors in patients with preserved ventricular function undergoing this surgery, there was a prospective observational study between May and July 2016 with a sample of 46 patients without ventricular dysfunction undergoing coronary artery bypass grafting with cardiopulmonary bypass, divided into two groups: complicated and uncomplicated. EuroSCORE were evaluated lactate levels in the peripheral arterial blood and the expression of HSPs 25,60,70,90 in the myocardial muscle and HSP 70 in the peripheral venous blood, and their correlations with complicated patients. Statistical analysis showed that the group with complicated evolution showed higher values ​​in the EuroSCORE; the blood lactate although significantly higher in patients with complicated evolution, has not proved an independent predictor for this category of patients. HSPs 25, 60, 70 proteins showed up significantly increased in the group of patients uncomplicated and modest values ​​in the other group, being the same HSP 70 expression in peripheral blood. HSP 25, with great power of discrimination complications, proved an independent predictor of protection. HSP 90 was not proven protecting factor for uncomplicated patients.