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[Change of serum endogenous digitalis-like substance undergoing cardiopulmonary bypass].

OBJECTIVE
To investigate the plasma concentrations and cardiac effects of endogenous digitalis-like substance (EDLS) before and after cardiopulmonary bypass (CPB).


METHODS
29 adults patients with NYHA II - IV, who suffered from congenital and acquired heart diseases, were included in this study. The plasma EDLS levels were determined by radioimmunoassay before and at the end of CPB, 2 h, 6 h, 24 h and 3 days after operation.


RESULTS
The plasma EDLS concentrations in NYHA IV patients [(403 +/- 27) pg/mL] were significantly higher than those in II [(221 +/- 98) pg/mL] and III patients [(296 +/- 71 pg/mL), P < 0.01] before CPB. CPB could induce the release of EDLS. The EDLS concentrations in plasma increased to (683 +/- 371) pg/mL and (577 +/- 274) pg/mL at 2 h and 6 h respectively after CPB, and went back to normal at 24 h after operation. However, there was no relationship between plasma EDLS concentration and the time of ascending aorta blocked at 2 h or 6 h after operation (r = 0.0748 and 0.0393 respectively). Over 50% patients in the higher EDLS (> 1000 pg/mL) group are NYHA IV, and the ratio was significantly higher than that in lower EDLS group (< 999 pg/ mL, P < 0.05). There was no difference between higher and lower EDLS groups in respect of the requirement of inotropic support and blood pressure.


CONCLUSIONS
The EDLS release can be induced by heart failure and CPB. The plasma EDLS concentrations increase up to climax in 2-6 h after CPB. The higher plasma EDLS concentration may improve the cardiac function.