The main challenge of this thesis was to evaluate whether the reperfused heart induced systemic effects postoperatively, contributing to morbidity and mortality after cardiac surgery. We identified... Show moreThe main challenge of this thesis was to evaluate whether the reperfused heart induced systemic effects postoperatively, contributing to morbidity and mortality after cardiac surgery. We identified preexisting processes in patients with heart failure, such as complement activation and influx of inflammatory cells in the myocardium. These changes in their turn altered the post-reperfusion response of the myocardium after cardiac surgery. Moreover, preexisting low-grade endothelial cell activation predicted the development of post-cardiac surgery vasoplegia. No evidence was found for oxidative damage after reperfusion in contrast to the current theory. As expected, targeting the inflammatory resposne with sevoflurane resulted in attenuation of pro-inflammatory markers, although no cardioprotective effects were observed. A stepwise approach in future research via preclinical to clinical studies, and vice versa, is ne cessary to ensure the integration of advancements in pathophysiological science with clinical trials Show less
