Does the Circadian Rhythm of Melatonin Affect Ischemia-Reperfusion Injury after Coronary Artery Bypass Grafting?

Authors

  • Onur Sokullu
  • Soner Sanio?lu
  • Erol Kurç
  • Murat Sargin
  • Hayati Deniz
  • Zeynep Tartan
  • Serap Aykut Aka
  • Fuat Bilgen

DOI:

https://doi.org/10.1532/HSF98.20081150

Abstract

Background: Melatonin is a potent scavenger of free radicals and an antioxidant. We studied the relationship between the protective effect of melatonin against ischemia-reperfusion injury (IRI) during cardiopulmonary bypass, the plasma level of melatonin, and the time of surgery.

Methods: Forty patients who were to undergo elective coronary artery bypass grafting (CABG) were divided into 2 groups, those who underwent their operations at 8 AM (group I; n = 20) and those who underwent their operations at 1 PM (group II; n = 20). The operations were carried out by the same surgical team and with the same standard surgical technique. Blood samples were collected before the operation (T1), when the aortic cross-clamp was removed (T2), and at 4 hours (T3) and 24 hours (T4) after the operation.

Results: Preoperative plasma levels of melatonin were substantially higher in group I than in group II. Intraoperative and postoperative melatonin levels were also significantly higher in patients who underwent their operations in the morning. The 2 groups had similar preoperative levels of intercellular adhesion molecule 1 and interleukin 8; however, intraoperative and postoperative values were lower in group I for all samples. This difference was statistically significant for both markers. Plasma levels of lactate dehydrogenase were significantly lower in group I. The 2 groups had similar aortic cross-clamp and cardiopulmonary bypass times. Preoperative and postoperative troponin I levels were lower in group I than in group II, but these differences were not statistically significant. The 2 groups showed no significant differences in plasma creatine kinase MB levels for either preoperative or postoperative measurements.

Conclusion: High plasma levels of melatonin may be directly related to low levels of IRI markers. Melatonin may have a protective effect against IRI in CABG. This effect seems to be directly correlated with the plasma levels of melatonin and inversely related with light. If melatonin protects myocardium from IRI, additional studies may be planned for the preoperative use of melatonin in patients with coronary artery disease to improve myocardial protection.

References

Brzezinski A. 1997. Melatonin in humans. N Engl J Med 336:186-95.nFourtillan JB, Brisson AM, Fourtillan M, Ingrand I, Decourt JP, Girault J. 2001. Melatonin secretion occurs at a constant rate in both young and older men and women. Am J Physiol Endocrinol Metab 280:E11-22.nGerritsen WB, van Boven WJ, Driessen AH, Haas FJ, Aarts LP. 2001. Off-pump versus on-pump coronary artery bypass grafting: oxidative stress and renal function. Eur J Cardiothorac Surg 20:923-39.nGuo X, Kuzumi E, Charman SC, Vuylsteke A. 2002. Perioperative melatonin secretion in patients undergoing coronary artery bypass grafting. Anesth Analg 94:1085-91.nHardeland R, Pandi Perumal SR. 2005. Melatonin, a potent agent in antioxidative defense: actions as a natural food contaminant, gastrointestinal factor, drug and prodrug. Nutr Metab 2:22-31.nKukielka GL, Smith CW, LaRosa GJ, et al. 1995. Interleukin-8 gene induction in the myocardium after ischemia and reperfusion in vivo. J Clin Invest 95:89-103.nLi YH, Teng JK, Tsai WC, Tsai LM, Lin LJ, Chen JH. 1997. Elevation of soluble adhesion molecules is associated with the severity of myocardial damage in acute myocardial infarction. Am J Cardiol 80:1218-21.nNowak JZ, Zawilska JB. 1998. Melatonin and its physiological and therapeutic properties. Pharm World Sci 20:18-27.nReiter RJ, Tan DX. 2003. Melatonin: a novel protective agent against oxidative injury of the ischemic-reperfused heart. Cardiovasc Res 58:10-9.nReiter RJ, Tan DX, Terron MP, Flores LJ, Czarnocki. 2007. Melatonin and its metabolites: new findings regarding their production and their radical scavenging actions. Acta Biochim Pol 54:1-9.nSakotnik A, Liebmann PM, Stoschitzky K, et al. 1999. Decreased melatonin synthesis in patients with coronary artery disease. Eur Heart J 20:1314-7.nTan DX, Chen LD, Poeggeler B, et al. 1993. Melatonin: a potent, endogenous hydroxyl radical scavenger. Endocr J 1:57-60.nYin YQ, Luo AL, Guo XY, Li LH, Huang YG. 2007. Postoperative neuropsychological change and its underlying mechanism in patients undergoing coronary artery bypass grafting. Chin Med J 120:1951-57.n

Published

2009-04-20

How to Cite

Sokullu, O., Sanio?lu, S., Kurç, E., Sargin, M., Deniz, H., Tartan, Z., Aka, S. A., & Bilgen, F. (2009). Does the Circadian Rhythm of Melatonin Affect Ischemia-Reperfusion Injury after Coronary Artery Bypass Grafting?. The Heart Surgery Forum, 12(2), E95-E99. https://doi.org/10.1532/HSF98.20081150

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