Objective: Nonocclusive mesenteric ischemia may occur after cardiac surgery, commonly in conjunction with the use of cardiopulmonary bypass. Some evidence suggests that endothelin-1 serum levels are increased in patients with mesenteric ischemia, but the association of endothelin-1 and nonocclusive mesenteric ischemia has not been studied. The objective was to investigate whether elevated levels of endothelin-1 could be found in patients exhibiting nonocclusive mesenteric ischemia.
Methods: In an observational cohort study, nonocclusive mesenteric ischemia developed in 78 of 865 patients undergoing elective cardiac surgery. Control patients were identified from the cohort through 1:1 propensity score matching. Preoperative and postoperative endothelin-1 serum levels were determined by means of enzyme-linked immunosorbent assay. Odds ratios (with 95% confidence interval) were calculated by logistic regression analyses to determine the risk of endothelin-1 for the development of nonocclusive mesenteric ischemia.
Results: Patients with nonocclusive mesenteric ischemia had higher preoperative (11.3 vs 9.3 pg/mL; P = .001) and postoperative (15.7 vs 11.1 pg/mL, P < .001) levels of endothelin-1 than the controls. The probability of developing nonocclusive mesenteric ischemia increased with each picogram/milliliter endothelin-1 level preoperatively (odds ratio, 1.29; 95% confidence interval, 1.12-1.49) and each picogram/milliliter postoperatively (odds ratio, 2.04; 95% confidence interval, 1.54-2.72). Receiver operating characteristic analyses showed that elevated endothelin-1 serum levels had a high accuracy to predict nonocclusive mesenteric ischemia (optimal cutoff value of 14.5 pg/mL, area under the curve of 0.77, sensitivity 51%, and specificity 94%).
Conclusions: Endothelin-1 seems to predispose patients undergoing cardiac surgery to develop nonocclusive mesenteric ischemia. In addition, it may be a useful marker to identify patients at risk for nonocclusive mesenteric ischemia after cardiac surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2014.12.019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Non-Occlusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.
Ann Vasc Surg
January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFLongitudinal analysis of serum intestinal fatty acid-binding protein in a patient with non-occlusive mesenteric ischemia following brachial plexus block-induced hypotension: a case study.
Clin J Gastroenterol
December 2024
Department of Nephrology, Saiseikai Niigata Kenoh Kikan Hospital, Sanjo, Niigata, 955-0091, Japan.
Intestinal fatty acid-binding protein (I-FABP) is a promising biomarker for small-bowel ischemia including non-occlusive mesenteric ischemia (NOMI). A 75-year-old woman with diabetic nephropathy sustained a distal radius fracture. Two days later, she underwent a brachial plexus block to facilitate orthopedic surgery, which resulted in hypotension.
View Article and Find Full Text PDFCase report of a case of acute pancreatitis (AP) at a patient previously known with essential thrombocytosis (ET). The most redoubtable complications of AP in this case were: pancreatic necrosis and splahnic vein thrombosis (SVT). Patient was followed-up for 3 months with complete resolution of SVT under anticoagulation.
View Article and Find Full Text PDFIncidence and predictors of gastrointestinal hemorrhage following mesenteric revascularization.
J Vasc Surg
November 2024
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN. Electronic address:
Objective: Postoperative gastrointestinal hemorrhage (GIH) following mesenteric revascularization when performed either openly (OR) or endovascularly (ER) has been clinically observed but not reported. The aim of the study is to assess the incidence and predictors of GIH in patients undergoing mesenteric revascularization.
Methods: This was a single-center retrospective review of consecutive patients treated with open or endovascular mesenteric revascularization from 2009 to 2019.
Computed Tomography Parameters for Prognosis Prediction in Non-Occlusive Mesenteric Ischemia.
Med Sci Monit
November 2024
Department of Radiology, Bolu Abant İzzet Baysal University Medical Faculty, Bolu, Turkey.
BACKGROUND Non-occlusive mesenteric ischemia (NOMI) is difficult to diagnose and has a high mortality rate. We aimed to determine the qualitative and quantitative parameters of computed tomography (CT) that can determine patient prognosis and contribute to early diagnosis in order to reduce mortality. MATERIAL AND METHODS The biphasic CT images of 40 patients, mean age 72.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!