Key result
Extracellular vesicles act as both injury mediators and potential cardioprotective therapies during cardiac surgery.
Why the study?
Cardiac surgery induces profound physiological stress, and extracellular vesicles have emerged as biomarkers and potential mediators of cardiovascular injury and repair requiring exploration.
Extracellular vesicles have a dual role in cardiac surgery as both mediators of perioperative injury and promising therapeutic targets for cardioprotection.
Answers are grounded in this paper and cite their sources.
Should not yet change perioperative practice in cardiac surgery; leaves open EV modulation as a hypothesis-generating cardioprotective target.
Cardiac surgery, while life-saving, induces profound physiological stress due to ischemia-reperfusion injury (IRI), systemic inflammation, and endothelial dysfunction, particularly in procedures involving cardiopulmonary bypass. In this complex setting, extracellular vesicles (EVs) have emerged as both biomarkers and potential mediators of cardiovascular injury and repair.This narrative review explores the multifaceted roles of EVs in cardiac surgery, with a focus on coronary artery bypass grafting (CABG) and valve repair or replacement. The review examines the diagnostic and therapeutic implications of circulating EVs and their role in graft patency, perioperative complications, myocardial protection, and vascular remodeling.We summarize current evidence regarding the biogenesis, classification, and engineering of EVs, highlighting their ability to transport bioactive molecules that modulate inflammation, coagulation, and apoptosis. In CABG, EVs have been linked to systemic inflammatory response, myocardial injury, and postoperative cognitive dysfunction. In valvular heart surgery and transcatheter procedures, endothelial- and platelet-derived EVs correlate with endothelial injury, shear stress, and postoperative outcomes. Preclinical studies indicate that stem cell-derived EVs exert cardioprotective effects by reducing apoptosis, promoting angiogenesis, and reprogramming macrophages.EVs represent a promising frontier in cardiac surgery, offering opportunities for risk stratification, real-time monitoring, and novel therapeutic strategies. Further translational research and standardized clinical protocols are needed to integrate EV profiling into perioperative care and to explore the full potential of EV-based therapies in cardioprotection and vascular healing.
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Carrozzo et al. (2025) conducted a review in Cardiac surgery (CABG, valve repair or replacement). Extracellular vesicles (EVs) was evaluated. Extracellular vesicles act as both mediators of cardiovascular injury and potential therapeutic agents for cardioprotection in patients undergoing cardiac surgery.
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