Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery
Purpose: To assess the impact of plasminogen/plasmin system components and matrix metalloproteases (MMPs) on the development of retinal artery occlusion (RAO) after cardiac surgery for valvular heart disease (VHD). Material and Methods: Seventy three patients who underwent cardiac surgery for VHD w...
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Ukrainian Society of Ophthalmologists
2024-12-01
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| Series: | Journal of Ophthalmology |
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| Online Access: | https://ua.ozhurnal.com/index.php/files/article/view/217 |
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| author | L.V. Natrus N.Ia. Kovalchuk I.S. Tanasiichuk Iu.O. Panchenko |
| author_facet | L.V. Natrus N.Ia. Kovalchuk I.S. Tanasiichuk Iu.O. Panchenko |
| author_sort | L.V. Natrus |
| collection | DOAJ |
| description | Purpose: To assess the impact of plasminogen/plasmin system components and matrix metalloproteases (MMPs) on the development of retinal artery occlusion (RAO) after cardiac surgery for valvular heart disease (VHD).
Material and Methods: Seventy three patients who underwent cardiac surgery for VHD were included in the study. Of these, 23 patients older than 60 years who had conventional-access mechanical prosthetic valve replacement with cardiopulmonary bypass were stratified into the group of high risk (HR) for RAO. Ten HR patients developed branch or central RAO. The low-risk (LR) group comprised 50 patients younger than 60 years who had valvuloplasty via a minimally invasive approach or the femoral artery using a biological implant. The control group comprised 15 patients who had no cardiac disease. Coagulogram indices and D-dimer were measured. Enzyme-linked immunosorbent assay kits were used to determine plasma plasminogen activator inhibitor (PAI)-1, plasmin-α2-antiplasmin complex (PAP), and tissue inhibitor of MMP-3 (TIMP-3) levels. MMP levels were determined by enzyme gelatin zymography.
Results: The PAI-1 levels were three times higher in HR groups than in controls. Mean PAI-1 levels were almost identical in patients who developed RAO and patients who did not develop RAO. The level of PAP in HR patients was 4-6 times lower than in the control group. MMP-9 activity was 2.5-fold lower in HR group patients who did not develop RAO than in those who developed RAO. In the latter patients, the level of plasma TIMP-3 was 2.3-fold lower than in controls. Mean plasma TIMP-3 level was almost identical in patients who did not develop RAO and LR patients. The mean plasma D-dimer level was the highest in patients who developed RAO; this was 16-fold higher than in the control group, and 11-fold higher than in patients who did not develop RAO.
Conclusion: High functional activity of plasmin and proteolytic MMP-9 activity are the major factors of the fibrinolytic system which cause the development of RAO in patients undergoing cardiac surgery. Regulators of plasminogen/plasmin activation (such as PAI-1 and PAP) and TIMP-3 do not play a substantial role in the development of complications in the form of RAO. |
| format | Article |
| id | doaj-art-030d78b8dc2641a78d6e944a6af64f20 |
| institution | Kabale University |
| issn | 2412-8740 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Ukrainian Society of Ophthalmologists |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-030d78b8dc2641a78d6e944a6af64f202025-01-07T10:17:57ZengUkrainian Society of OphthalmologistsJournal of Ophthalmology2412-87402024-12-016333910.31288/oftalmolzh202463339Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgeryL.V. Natrus0N.Ia. Kovalchuk1https://orcid.org/0009-0005-6548-3095I.S. Tanasiichuk2Iu.O. Panchenko3Bogomolets National Medical University, Ministry of Health of UkraineSI “Heart Institute of the Ministry of Health of Ukraine”Bogomolets National Medical University, Ministry of Health of UkraineSchupyk National Healthcare University of Ukraine, Ministry of Health of UkrainePurpose: To assess the impact of plasminogen/plasmin system components and matrix metalloproteases (MMPs) on the development of retinal artery occlusion (RAO) after cardiac surgery for valvular heart disease (VHD). Material and Methods: Seventy three patients who underwent cardiac surgery for VHD were included in the study. Of these, 23 patients older than 60 years who had conventional-access mechanical prosthetic valve replacement with cardiopulmonary bypass were stratified into the group of high risk (HR) for RAO. Ten HR patients developed branch or central RAO. The low-risk (LR) group comprised 50 patients younger than 60 years who had valvuloplasty via a minimally invasive approach or the femoral artery using a biological implant. The control group comprised 15 patients who had no cardiac disease. Coagulogram indices and D-dimer were measured. Enzyme-linked immunosorbent assay kits were used to determine plasma plasminogen activator inhibitor (PAI)-1, plasmin-α2-antiplasmin complex (PAP), and tissue inhibitor of MMP-3 (TIMP-3) levels. MMP levels were determined by enzyme gelatin zymography. Results: The PAI-1 levels were three times higher in HR groups than in controls. Mean PAI-1 levels were almost identical in patients who developed RAO and patients who did not develop RAO. The level of PAP in HR patients was 4-6 times lower than in the control group. MMP-9 activity was 2.5-fold lower in HR group patients who did not develop RAO than in those who developed RAO. In the latter patients, the level of plasma TIMP-3 was 2.3-fold lower than in controls. Mean plasma TIMP-3 level was almost identical in patients who did not develop RAO and LR patients. The mean plasma D-dimer level was the highest in patients who developed RAO; this was 16-fold higher than in the control group, and 11-fold higher than in patients who did not develop RAO. Conclusion: High functional activity of plasmin and proteolytic MMP-9 activity are the major factors of the fibrinolytic system which cause the development of RAO in patients undergoing cardiac surgery. Regulators of plasminogen/plasmin activation (such as PAI-1 and PAP) and TIMP-3 do not play a substantial role in the development of complications in the form of RAO.https://ua.ozhurnal.com/index.php/files/article/view/217retinaretinal artery occlusionvalvular heart diseasecardiosurgical interventionsplasminogen/plasmin systemmmp-9 |
| spellingShingle | L.V. Natrus N.Ia. Kovalchuk I.S. Tanasiichuk Iu.O. Panchenko Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery Journal of Ophthalmology retina retinal artery occlusion valvular heart disease cardiosurgical interventions plasminogen/plasmin system mmp-9 |
| title | Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| title_full | Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| title_fullStr | Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| title_full_unstemmed | Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| title_short | Role of plasminogen/plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| title_sort | role of plasminogen plasmin system components and matrix metalloproteases in retinal artery occlusion following cardiac surgery |
| topic | retina retinal artery occlusion valvular heart disease cardiosurgical interventions plasminogen/plasmin system mmp-9 |
| url | https://ua.ozhurnal.com/index.php/files/article/view/217 |
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