Kinetics of endocan after cardiac surgery

• Research type

  Research Study

• Full title

  Changes in plasma endocan level after cardiac surgery

• IRAS ID

  145815

• Contact name

  Vivek Sharma

• Contact email

  vivek.sharma@stgeorges.nhs.uk

• Sponsor organisation

  St George's Hospital

• Research summary

  Endocan (endothelial cell specific molecule, ESM-1) is a proteoglycan expressed by endothelial cells in the lung [1]. By binding to integrin leukocyte function-associated antigen–1 on the surface of blood cells, endocan inhibits leukocyte recruitment into the lungs [2]. Lower levels of endocan have found to be associated with the development of acute lung injury (ALI) in patients with trauma [3].
  Cardiac surgery induces a systemic inflammatory state, which may give rise to inflammatory lung injury. Cardiac surgery thus is a known risk factor for acute respiratory distress syndrome (ARDS), a severe form of ALI [4]. ARDS is associated with a high postoperative morbidity and mortality. Early prediction of this potentially lethal complication would allow prompt instigation of targeted preventive measures, and decrease likelihood of it’s development.

  Endocan has shown promise as biomarker to predict ALI in trauma patients. Endocan levels may also correlate with the occurence of ALI in cardiac surgical patients.

  There is no existing information on the kinetics of endocan in patients undergoing cardiac surgery. In the proposed study we will measure serum endocan levels in patients undergoing elective cardiac surgery at fixed time points in the perioperative period. The hypothesis is that patients undergoing elective coronary artery surgery without the use of cardiopulmonary bypass will have a lower inflammatory response than those patients undergoing coronary artery surgery with the use of cardiopulmonary bypass. Furthermore, patients undergoing complex multi-procedural cardiac surgery may develop a higher inflammatory response than coronary artery surgery patients. Patients with higher levels of inflammation may be at higher risk of developing ALI and ARDS postoperatively.

  The results of the study would provide valuable information and enable a clinical study looking to correlate lung injury following cardiac surgery with plasma endocan levels.

• REC name

  London - Camberwell St Giles Research Ethics Committee

• REC reference

  14/LO/0459

• Date of REC Opinion

  7 Mar 2014

• REC opinion

  Favourable Opinion