Eastern Cardiothoracic Surgical Society

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Protective effects of 17β-estradiol on liver injury after occlusion of the proximal portion of descending aorta in male rats
Marcelo Luiz Peixoto Sobral, Ricardo Ribeiro Dias, Cristiano de Jesus Correia, Aline Santos de Almeida, Roberto Armstrong Jr, Fbio Biscegli Jatene, Ana Cristina Breithaupt-Faloppa, Luiz Felipe Pinho Moreira.
INCOR, So Paulo, Brazil.

OBJECTIVE: Aortic diseases maintain high mortality and morbidity, and their surgical treatment may compromise the gastrointestinal tract. Previous experimental study showed that prophylactic steroid 17β-estradiol was able to reduce this injury. Here we intended to investigate estradiol influence on secondary coagulation and liver response after ischemic-reperfusion (I/R) injury due to thoracic aorta occlusion.
METHODS: Wistar male rats were randomized and allocated in three groups: (Sham) surgically manipulated only (n=10); (IR) animals submitted to aortic occlusion for 20 minutes, followed by reperfusion for up to 2 hours (n=10) and (E2) animals treated with 17β-estradiol (E2, 280 g/kg, i.v.) 30 minutes before I/R (n=10). The coagulation (thromboelastometry and platelet aggregation), liver histopathological status, apoptosis and vascular response were evaluated
RESULTS: IR group presented increased platelet aggregation (Sham=45.1, IR=79.1, E2=40.8%; P=0.02). The clot firmness was also significantly higher in IR group (Sham=65.8, IR=80.4, E2=68.9mm; P=0.012) and IR presented lower concentration of fibrinogen and a longer time of activation of this factor. Besides the reduction of platelet aggregation and clot firmness, E2 treatment was also able to increase fibrinogen after I/R injury. Histological evaluation of the livers did not show differences among the in edema or cell infiltrate, but there was an increase in hepatic AST and ALT activity in both groups I/R . Moreover, liver eNOS expression and the anti-apoptotic molecule BCL-2 were increased by estradiol (Sham=0.22, IR=0.12, E2=0.19; P=0.0002).
CONCLUSIONS: The data indicated that 17β-estradiol prophylactic infusion was protective on coagulation, vascular response and apoptosis after I/R injury.


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