Background: The aim of this study was to characterize the influence of cardiopulmonary bypass (CPB) on myocardial remodeling in newborns and children.
Methods: Biopsies from the right atrium were taken before and after CPB from 4 newborns (5-11 days old) and 7 children (8 months-16 years old). Immunostainings on 10 µm heart tissue frozen sections were performed to detect c-kit cells, leukocytes (CD45 cells), Ki67 cycling cells. The percentage of 8-hydroxy-guanosine (8-dOHG)cardiomyocytes and non-cardiomyocytes [(8-dOHG)-index] were determined to quantify oxidative stress.
Results: Δ c-kitCD45 cells (resident cardiac stem cells) were increased in newborns (2.2 ± 1.9/mm) and decreased in children - 1.5 ± 0.7/mm, p < 0.01. The (8-dOHG)-index was reduced by 43% in newborns and by 20% in children. CPB did not influence cardiac cell turnover; high cell proliferation was seen in newborns before and after CPB. Cardiopulmonary bypass significantly decreased the leucocyte infiltration in newborns to 40 ± 8%, p < 0.05, but not in children. Infiltration with eosinophils (eosinophils/CD45%) was completely abolished in the myocardium of newborns p < 0.05 and reduced to 22 ± 8% in children after CPB, n.s.
Conclusions: Immediate response and remodeling of the myocardium to CPB differs between newborns, older infants and children. Especially an increased number of c-kit expressing CD45 cells after CPB were seen in neonates in comparison to children. The clinical value of such observation needs to be further assessed in larger cohorts of patients.
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| http://dx.doi.org/10.1186/s12967-018-1478-7 | DOI Listing |
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