Association Between Cardiopulmonary Bypass–Induced Sirtuin-1 Suppression and Apoptosis

Objectives: The aim of this study is to investigate, at the molecular level, the effect of cardiopulmonary bypass (CPB) on Sirtuin-1 levels, an epigenetic-metabolic regulatory protein, and the relationship between this change and Caspase-3, one of the key executor molecules of cellular apoptosis. Methods: Patients undergoing open heart surgery under CPB were included in the study. Sirtuin-1 and Caspase-3 levels were measured in venous blood samples taken from patients during the preoperative, intraoperative, and postoperative periods. The Wilcoxon Signed Ranks test was used to analyze differences between time points. Results: Sirtuin-1 levels decreased significantly during the intraoperative period compared to preoperative values (Z= -6.212, P<0.001). Similarly, postoperative Sirtuin-1 levels were significantly lower compared to both the preoperative (Z= -6.229, P<0.001) and intraoperative periods (Z= -6.186, P<0.001). Caspase-3 levels showed a significant increase in the intraoperative period compared to the preoperative period (Z= −6.262, P<0.001). Postoperative Caspase-3 levels were significantly higher than both the preoperative (Z= -6.196, P<0.001) and intraoperative periods (Z= -6.203, p < 0.001). Conclusions: These findings indicate that CPB suppresses circulating Sirtuin-1 levels and that this suppression is associated with increased apoptosis. CPB-induced Sirtuin-1 inhibition may be one of the molecular mechanisms of surgical-related cellular damage. Sirtuin-1 may be considered a potential molecular target for preventing CPB-related myocardial and systemic damage.