The Annals of thoracic surgeryNov 28, 2006

Stress hormone responses in patients having open heart surgery with or without heart-lung machine support

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

Leptin serum levels decreased to 73.2% of baseline in patients undergoing conventional coronary artery bypass grafting during open heart surgery.

Leptin levels decreased significantly during surgery in patients with cardiopulmonary bypass, with varying recovery patterns postoperatively.
Two hours after surgery, leptin levels were 85.3% of baseline in heart valve surgery patients and only 38.9% in off-pump coronary artery bypass grafting patients.
By 24 hours postoperatively, leptin levels increased to 218.6% of baseline in conventional bypass patients and 313.7% in heart valve surgery patients.
In contrast, patients undergoing off-pump surgery showed only a moderate increase in serum leptin levels.
Cortisol levels peaked at 532.9% of baseline in conventional bypass patients and 526.4% in heart valve surgery patients 12 hours postoperatively, while reaching 280% in off-pump patients.

Simplified

BACKGROUND: Cardiopulmonary bypass often causes a stress hormonal response with subsequent changes in hemodynamics and organ perfusion. Leptin, an adipocyte-derived factor, has been proposed to play a role in systemic inflammation. We examined perioperative release of leptin and cortisol in patients undergoing open heart surgery with or without cardiopulmonary bypass.

METHODS: Forty-nine patients were enrolled in this prospective study. Conventional coronary artery bypass grafting was performed in 19 patients (ONCABG; group I), and heart valve surgery in 15 patients (group II). Fifteen patients (group III) received off-pump coronary artery bypass grafting (OPCABG). Blood samples were collected preoperatively and for as long as 72 hours postoperatively. Plasma levels of leptin and cortisol were measured by enzyme-linked immunosorbent assay.

RESULTS: Leptin serum levels decreased during the operation, reaching 73.2% of the baseline in group I, 85.3% in group II, and 38.9% in group III (p < 0.05), 2 hours postoperatively. Thereafter, leptin levels increased gradually to 218.6% of the baseline in group I and 313.7% in group II 24 hours after the operation (p < 0.01). However, patients in the OPCABG group showed only a moderate increase in serum leptin levels. Plasma cortisol levels rose to a maximum of 532.9% of baseline in group I, 526.4% in group II, and 280% in group III 12 hours postoperatively (p < 0.01).

CONCLUSIONS: Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors leptin and cortisol. A different pattern of leptin and cortisol release was observed in patients operated on without cardiopulmonary bypass.

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Stress hormone responses in patients having open heart surgery with or without heart-lung machine support

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