AUTHOR=Longchamp Alban , MacArthur Michael R. , Trocha Kaspar , Ganahl Janine , Mann Charlotte G. , Kip Peter , King William W. , Sharma Gaurav , Tao Ming , Mitchell Sarah J. , Ditrói Tamás , Yang Jie , Nagy Péter , Ozaki C. Keith , Hine Christopher , Mitchell James R. 

TITLE=Plasma Hydrogen Sulfide Is Positively Associated With Post-operative Survival in Patients Undergoing Surgical Revascularization

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.750926

DOI=10.3389/fcvm.2021.750926

ISSN=2297-055X

ABSTRACT=<p><bold>Objective:</bold> Hydrogen sulfide (H<sub>2</sub>S) is a gaseous signaling molecule and redox factor important for cardiovascular function. Deficiencies in its production or bioavailability are implicated in atherosclerotic disease. However, it is unknown if circulating H<sub>2</sub>S levels differ between vasculopaths and healthy individuals, and if so, whether H<sub>2</sub>S measurements can be used to predict surgical outcomes. Here, we examined: (1) Plasma H<sub>2</sub>S levels in patients undergoing vascular surgery and compared these to healthy controls, and (2) the association between H<sub>2</sub>S levels and mortality in a cohort of patients undergoing surgical revascularization.</p><p><bold>Methods:</bold> One hundred and fifteen patients undergoing carotid endarterectomy, open lower extremity revascularization or lower leg amputation were enrolled at a single institution. Peripheral blood was also collected from a matched control cohort of 20 patients without peripheral or coronary artery disease. Plasma H<sub>2</sub>S production capacity and sulfide concentration were measured using the lead acetate and monobromobimane methods, respectively.</p><p><bold>Results:</bold> Plasma H<sub>2</sub>S production capacity and plasma sulfide concentrations were reduced in patients with PAD (<italic>p</italic> &lt; 0.001, <italic>p</italic> = 0.013, respectively). Patients that underwent surgical revascularization were divided into high vs. low H<sub>2</sub>S production capacity groups by median split. Patients in the low H<sub>2</sub>S production group had increased probability of mortality (<italic>p</italic> = 0.003). This association was robust to correction for potentially confounding variables using Cox proportional hazard models.</p><p><bold>Conclusion:</bold> Circulating H<sub>2</sub>S levels were lower in patients with atherosclerotic disease. Patients undergoing surgical revascularization with lower H<sub>2</sub>S production capacity, but not sulfide concentrations, had increased probability of mortality within 36 months post-surgery. This work provides insight on the role H<sub>2</sub>S plays as a diagnostic and potential therapeutic for cardiovascular disease.</p>