{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:58:28Z","timestamp":1785376708440,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative pulmonary decline is an established complication of open\u2010heart surgery extending beyond the immediate postoperative phase. Inflammation\u2010mediated lung damage and ischaemia\u2010reperfusion injury secondary to extracorporeal circulation is a proposed pathophysiological driver. GLP\u20101 receptor agonists (GLP\u20101RA) have emerged as promising protective agents in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Investigate whether infusion of the GLP\u20101RA, exenatide during cardiopulmonary bypass and weaning thereof, can mitigate the decline in diffusing capacity and ventilatory performance 3\u2009months postoperative, compared to placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this predefined explorative substudy of the randomised, clinical GLORIOUS trial, 878 adult patients undergoing non\u2010emergent coronary artery bypass grafting (CABG) and\/or surgical aortic valve replacement (SAVR) were randomised to a continuous infusion of the GLP\u20101RA, exenatide or placebo during cardiopulmonary bypass, extending into the early postoperative period. Diffusing capacity of the lung for carbon monoxide (DLCO) and ventilatory performance (FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC) were measured preoperatively and 3\u2009months postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median DLCO (% predicted corrected) declined from 80% preoperative to 72% 3\u2009months postoperative, corresponding to a \u22127.7 percentage point (pp) difference (95% CI 6.2 to 9.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC declined from 0.75 preoperative to 0.73 postoperative, corresponding to a \u22121.6 difference (95% CI 1.0 to 2.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, there were no significant differences in decline between the exenatide and placebo groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.3). Findings were consistent across subgroup analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While both diffusing capacity and ventilatory performance exhibited a mild\u2010to\u2010moderate decline 3\u2009months after open\u2010heart surgery, the GLP\u20101RA exenatide did not mitigate this decline compared with placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>\n                      Pulmonary dysfunction is one of the most common complications to open\u2010heart surgery. The present study confirms a decline in diffusing capacity of the lung for carbon monoxide (DLCO) and in ventilatory performance measured as FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC at 3\u2009months postoperatively compared to preoperative measurements. Infusion of GLP\u20101\u2009receptor antagonist during cardiopulmonary bypass and weaning did not mitigate the pulmonary decline compared to placebo.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70282","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:22:06Z","timestamp":1781868126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Glucagon\u2010Like Peptide\u20101 Agonist vs. Placebo and Pulmonary Decline After Open\u2010Heart Surgery: A Substudy of the\n                    <scp>GLORIOUS<\/scp>\n                    Randomised Clinical Trial"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8887-8525","authenticated-orcid":false,"given":"Astrid Duus","family":"Mikkelsen","sequence":"first","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Wiberg","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Anaesthesiology and Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Henrik Lawaetz","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Section for Heart\u2010and Lung Transplant Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Hasse","family":"M\u00f8ller\u2010S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Anaesthesiology and Intensive Care Copenhagen University Hospital  Copenhagen 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