Using Next-generation RNA Sequencing to Examine Ischemic Changes Induced by Cold Blood Cardioplegia on the Human Left Ventricular Myocardium Transcriptome. (March 2015)

• Record Type: Journal Article
• Authors: Muehlschlegel, Jochen D.; Christodoulou, Danos C.; McKean, David; Gorham, Joshua; Mazaika, Erica; Heydarpour, Mahyar; Lee, Grace; DePalma, Steven R.; Perry, Tjorvi E.; Fox, Amanda A.; Shernan, Stanton K.; Seidman, Christine E.; Aranki, Sary F.; Seidman, Jon G.; Body, Simon C.
• Is Part Of: Anesthesiology. Volume 122:Number 3(2015)
• Publication Date: 2015-03
• Subjects: Anesthesiology -- Periodicals; Anesthetics -- Periodicals; Anesthesia -- Periodicals; 617.9605
• DOI: 10.1097/ALN.0000000000000582
• Languages: English
• ISSNs: 0003-3022

Abstract

Abstract : Background: The exact mechanisms that underlie the pathological processes of myocardial ischemia in humans are unclear. Cardiopulmonary bypass with cardioplegic arrest allows the authors to examine the whole transcriptional profile of human left ventricular myocardium at baseline and after exposure to cold cardioplegia-induced ischemia as a human ischemia model. Methods: The authors obtained biopsies from 45 patients undergoing aortic valve replacement surgery at baseline and after an average of 79 min of cold cardioplegic arrest. Samples were RNA sequenced and analyzed with the Partek ® Genomics Suite (Partek Inc., St. Louis, MO) for differential expression. Ingenuity Pathway Analysis (Ingenuity Systems, Redwood City, CA) and Biobase ExPlain (Biobase GmbH, Wolfenbuettel, Germany) systems were used for functional and pathway analyses. Results: Of the 4, 098 genes with a mean expression value greater than 5, 90% were down-regulated and 9.1% were up-regulated. Of those, 1, 241 were significantly differentially expressed. Gene ontology analysis revealed significant down-regulation in immune inflammatory response and complement activation categories and highly consistent was the down-regulation of intelectin 1, proteoglycan, and secretory leukocyte peptidase inhibitor. Up-regulated genes of interest were FBJ murine osteosarcoma viral oncogene homolog and the hemoglobin genes hemoglobin α1 (HBA1) and hemoglobin β. In addition, analysis of transcription factor–binding sites revealed interesting targets in factors regulating reactive oxygen species production, apoptosis, immunity, cytokine production, and inflammatory response. Conclusions: The authors have shown that the human left ventricle exhibits significant changes in gene expression in response to cold cardioplegia-induced ischemia during cardiopulmonary bypass, which provides great insight into the pathophysiology of ventricular ischemia, and thus, may help guide efforts to reduce myocardial damage during surgery. Abstract : The authors have performed a comprehensive genomic analysis of human heart exposed to cold cardioplegia-induced myocardial ischemia providing novel information regarding gene regulation during ischemia. The results further our understanding of the pathological response of the human heart to stress and identify novel interventional targets for future therapies.Supplemental Digital Content is available in the text.