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Microvascular dysfunction in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass

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Purpose of review

The purpose of the current review is to describe the changes of microvascular function in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass (CPB) and cardiac surgery.

Recent findings

Cardiac surgery, especially that involving cardioplegia and CPB, is associated with significant changes in vascular reactivity of coronary/peripheral microcirculation, vascular permeability, gene/protein expression, and programmed cell death, as well as with increased morbidity and mortality after surgical procedures. In particular, these changes are more profound in patients with poorly controlled diabetes.Summary

Because alterations in vasomotor regulation are critical aspects of mortality and morbidity of cardioplegia/CPB, a better understanding of diabetic regulation of microvascular function may lead to improved postoperative outcomes of patients with diabetes after cardioplegia/CPB and cardiac surgery.
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Keywords: cardiac surgery; cardioplegia; cardiopulmonary bypass; diabetes mellitus; microvascular dysfunction

Document Type: Research Article

Affiliations: 1: Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Rhode Island Hospital, Rhode Island, USA, Both the authors contributed equally to the writing of this article. 2: Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Rhode Island Hospital, Rhode Island, USA, Both the authors contributed equally to the writing of this article.

Publication date: November 1, 2016

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