Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Gene Test Determines Risk of Heart Surgery Complications

01.05.2009
Genetic differences can explain why some patients undergoing heart surgery later experience shock and kidney complications, according to a study by researchers at the Charité - Universitätsmedizin Berlin, the Max-Delbrück-Center for Molecular Medicine (MDC) Berlin-Buch in Germany and the Austin Hospital in Melbourne, Australia.

The results indicate that performing a genetic test on patients before they have surgery can help guide treatment after they leave the operating room (Journal of the American Society of Nephrology, JASN, doi 10.1681/ASN.2008080915)*.

The researchers studied the gene that encodes the enzyme catechol-O-methyltransferase (COMT). Certain variants of the COMT gene have long been suspected to play a role in shock and kidney failure in patients following heart surgery. The COMT enzyme is involved in metabolizing norepinephrine (noradrenalin), a drug that is given to patients post-surgery to stimulate their blood flow and to normalize their blood pressure.

Professor Duska Dragun, MD, Charité, Professor Friedrich Luft, MD (Experimental and Clinical Research Center , MDC) and Dr. Wolf-Hagen Schunck (MDC) studied the COMT gene in 260 patients who underwent heart bypass surgery. They were able to show that the genetic variant they call "LL" can lower the activity of the COMT enzyme. As a result, LL patients are more likely to develop shock and kidney failure.

In addition, LL patients who experience shock do not respond very well to treatment with norepinephrine. Since the activity of the COMT enzyme is lowered in LL patients, norepinephrine cannot fully be metabolized. As a result, too much norepinephrine remains in the body and the drug is no longer effective.

Therefore, the researchers suggest that "perhaps, more suitable hemodynamics could be achieved in LL patients were they given vasopressin rather than noradrenaline (norepinephrine) and acute kidney injury might be attenuated by avoidance of cardiopulmonary bypass and nephrotoxic medication." Larger clinical trials are necessary to show whether patients need to undergo genetic testing prior to heart surgery to determine their risk for shock and kidney failure.

Decreased Catecholamine Degradation Associates with Shock and Kidney Injury after Cardiac Surgery

Anja Haase-Fielitz,*? Michael Haase,*? Rinaldo Bellomo,* Gavin Lambert,? George Matalanis,§ David Story,§ Laurie Doolan,§ Brian Buxton,§ Geoff Gutteridge,* Friedrich C. Luft,II Wolf-Hagen Schunck,¶ and Duska Dragun?**

*Department of Intensive Care, Austin Health, Melbourne, Australia; ?Department of Nephrology and Intensive Care Medicine, Campus Virchow Clinic, Medical Faculty of the Charité, Berlin, Germany; ?Baker Heart Research Institute, Melbourne, Australia; §Departments of Anaesthesiology and Cardiac Surgery, Austin Health, Melbourne, Australia; _Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and HELIOS Klinikum, Berlin, Germany; ¶Max Delbrück Center for Molecular Medicine, Berlin, Germany; **Center for Cardiovascular Research, Charité, Berlin, Germany

Barbara Bachtler
Press and Public Affairs
Max Delbrück Center for Molecular Medicine (MDC) Berlin-Buch
Robert-Rössle-Straße 10; 13125 Berlin; Germany
Phone: +49 (0) 30 94 06 - 38 96
Fax: +49 (0) 30 94 06 - 38 33
e-mail: presse@mdc-berlin.de

Barbara Bachtler | Max-Delbrück-Centrum
Further information:
http://www.mdc-berlin.de/
http://jasn.asnjournals.org/

More articles from Life Sciences:

nachricht Topologische Quantenchemie
21.07.2017 | Max-Planck-Institut für Chemische Physik fester Stoffe

nachricht Topological Quantum Chemistry
21.07.2017 | Max-Planck-Institut für Chemische Physik fester Stoffe

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

Im Focus: The proton precisely weighted

What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.

To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...

Im Focus: On the way to a biological alternative

A bacterial enzyme enables reactions that open up alternatives to key industrial chemical processes

The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....

Im Focus: The 1 trillion tonne iceberg

Larsen C Ice Shelf rift finally breaks through

A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...

Im Focus: Laser-cooled ions contribute to better understanding of friction

Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision

Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Closing the Sustainability Circle: Protection of Food with Biobased Materials

21.07.2017 | Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

The technology with a feel for feelings

12.07.2017 | Event News

 
Latest News

Chances to treat childhood dementia

24.07.2017 | Health and Medicine

Improved Performance thanks to Reduced Weight

24.07.2017 | Automotive Engineering

NASA looks to solar eclipse to help understand Earth's energy system

21.07.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>