Evidence map›Paper›PMID 27697359›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2017

Mast cell activation and arterial hypotension during proximal aortic repair requiring hypothermic circulatory arrest.

Miklos D Kertai, Sreekanth Cheruku, Wenjing Qi, Yi-Ju Li, G Chad Hughes, Joseph P Mathew, Jörn A Karhausen

Open access · bronzeAbstract readVideo-Audio Media
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. SUMOylation Regulates Neutrophil Phagocytosis and Migration.Pharmaceuticals (Basel, Switzerland) · 2025
    Article
  2. Article
  3. Mast Cell Chymase and Kidney Disease.International journal of molecular sciences · 2020
    Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Miklos D KertaiDivision of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
Sreekanth CherukuDivision of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
Wenjing QiDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC.
Yi-Ju LiDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC; Molecular Physiology Institute, Duke University Medical Center, Durham, NC.
G Chad HughesDivision of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Joseph P MathewDivision of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
Jörn A KarhausenDivision of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC. Electronic address: jorn.karhausen@duke.edu.
Duke Medical Center · USDuke University · USDuke University Hospital · US

Funding

Lidocaine for Neuroprotection During Cardiac SurgeryR01HL096978 · NHLBI · DUKE UNIVERSITY · PI MATHEW, JOSEPH P · 2009 to 2013
$1.8M
Cortical Beta-amyloid Levels and Neurocognitive Performance After Cardiac SurgeryR21HL108280 · NHLBI · DUKE UNIVERSITY · PI MATHEW, JOSEPH P · 2011 to 2012
$432k
Functional Connectivity Changes In Attention Networks after Cardiac SurgeryR21HL109971 · NHLBI · DUKE UNIVERSITY · PI BROWNDYKE, JEFFREY N, MATHEW, JOSEPH P · 2012 to 2013
$422k
Platelet/Mast Cell Interactions as Determinants of End-Organ Injury in Cardiac SurgeryR56HL126891 · NHLBI · DUKE UNIVERSITY · PI KARHAUSEN, JORN · 2015 to 2015
$414k
NHLBI NIH HHS R01 HL096978NHLBI NIH HHS R21 HL108280NHLBI NIH HHS R21 HL109971NHLBI NIH HHS R56 HL126891
6 · The paper itself

Abstract

objectiveAortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated their role in intraoperative hypotension.

methodsWe studied 31 patients undergoing proximal aortic repair with hypothermic circulatory arrest between June 2013 and April 2015 at Duke University Medical Center. Plasma samples were obtained at different intraoperative time points to quantify chymase, interleukin-6, interleukin-8, tumor necrosis factor alpha, and white blood cell CD11b expression. Hypotension was defined as the area (minutes × millimeters mercury) below a mean arterial pressure of 55 mm Hg. Biomarker responses and their association with intraoperative hypotension were analyzed by 2-sample t test and Wilcoxon rank sum test. Multivariable logistic regression analysis was used to examine the association between clinical variables and elevated chymase levels.

resultsMast cell-specific chymase increased from a median 0.97 pg/mg (interquartile range [IQR], 0.01-1.84 pg/mg) plasma protein at baseline to 5.74 pg/mg (IQR, 2.91-9.48 pg/mg) plasma protein after instituting cardiopulmonary bypass, 6.16 pg/mg (IQR, 3.60-9.41 pg/mg) plasma protein after completing circulatory arrest, and 7.64 pg/mg (IQR, 4.63-12.71 pg/mg) plasma protein after weaning from cardiopulmonary bypass (each P value < .0001 vs baseline). Chymase was the only biomarker associated with hypotension during (P = .0255) and after (P = .0221) cardiopulmonary bypass. Increased temperatures at circulatory arrest and low presurgical hemoglobin levels were independent predictors of increased chymase responses.

conclusionsMast cell activation occurs in cardiac surgery requiring cardiopulmonary bypass and hypothermic circulatory arrest and is associated with intraoperative hypotension.

Indexed as

Intraoperative ComplicationsAorta, ThoracicAortic DiseasesBlood PressureCirculatory Arrest, Deep Hypothermia InducedCytokinesFemaleFollow-Up StudiesHumansHypotensionInflammationMaleMast CellsMiddle AgedPilot ProjectsRetrospective StudiesCytokinesblood pressurecardiac surgical proceduresinflammation mediatorsmast cell

Identifiers

PMID27697359
PMCPMC5164847
OpenAlexW2518873924

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.