The relationship between size distribution of circulating extracellular vesicles and coagulation function after cardiac surgery
10.3760/cma.j.cn112434-20241231-00337
- VernacularTitle:循环细胞外囊泡粒径特征与体外循环心脏手术后凝血功能的关系
- Author:
Hongyu CAO
1
;
Haoxiang YUAN
1
;
Chao CHEN
1
;
Yupeng JIAN
1
;
Yuquan LI
1
;
Xiaojun LIU
1
;
Zhensheng MA
1
;
Yan LI
1
;
Jingsong OU
1
Author Information
1. 中山大学附属第一医院心脏外科 血管疾病诊治技术国家地方联合工程实验室(广东) 国家卫健委辅助循环重点实验室(中山大学) 中国医学科学院辅助循环及血管相关疾病重点实验室 广东省血管疾病诊治工程技术研究中心 广东省脑功能与脑疾病重点实验室，广州 510080
- Publication Type:Journal Article
- Keywords:
Extracellular vesicles;
Cardiac surgery;
Coagulation;
Cardiopulmonary bypass
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(3):183-190
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the changes in extracellular vesicles (EVs) size distribution before and after cardiopulmonary bypass (CPB) cardiac surgery and postoperative coagulation function.Methods:A total of 103 patients undergoing cardiac surgery with CPB were enrolled. Venous blood samples were collected at preoperation, postoperative 12 h and 3 days. Additionally, 50 age- and gender-matched healthy volunteers served as a control group. EVs were isolated using gradient centrifugation, and their size distribution was assessed by dynamic light scattering (DLS). The relationship between EV size characteristics, including peak diameter, peak height, and interquartile range( IQR), and postoperative coagulation function was analyzed. Results:Compared to patients with normal postoperative coagulation function, those with postoperative coagulation dysfunction had lower size at peak and IQR, and significantly higher peak intensity. Logistic regression analysis indicated that elevated peak intensity and lower size at peak and IQR were risk factors for coagulation dysfunction. The area under the curve ( AUC) for diagnosing coagulation dysfunction with 12 h postoperative EVs peak intensity was 0.76, with a positive predictive value of 85% at the optimal cutoff of 8.2; the AUC for IQR was 0.84, with a sensitivity of 83%, specificity of 82%, and negative predictive value of 86% at the optimal cutoff of 125.05 nm. Conclusion:The size distribution of circulating EVs show a correlation with coagulation function after cardiac surgery with CPB and may serve as a novel biomarker to predict postoperative coagulation dysfunction.
