Proinflammatory cytokines and myocardial viability in patients after acute myocardial infarction
Proinflammatory cytokines and myocardial viability in patients after acute myocardial infarction
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DOI：
10.1016/j.ijcard.2004.03.067
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发表时间：
2005-06-08
影响因子：
3.5
通讯作者：
Mazurek, W
中科院分区：
文献类型：
--
作者：
Kosmala, W;Przewlocka-Kosmala, M;Mazurek, W
背景资料：促炎细胞因子如肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）可在急性心肌梗死（AMI）期间加强心肌损伤。急性心肌梗死后其血浆水平的变化是否依赖于心肌存活性尚不清楚。本研究的目的是估计血浆TNF-α和IL-6的时间进程的关系和存在的可逆性和不可逆的心肌功能障碍的患者AMI后早期溶栓treatedthrombolytic.Material和方法：患者（54;平均年龄60.4 +/- 11.7岁）AMI血浆TNF-α和IL-6进行了评价，在溶栓后第2，第10和第30天。根据第10天多巴酚丁胺负荷超声心动图检查时心肌功能障碍节段的反应，将患者分为4组：A组，收缩力持续改善; B组，双相（改善后恶化）; C组，仅恶化; D组，无变化。22名健康人作为controls.Results：在第2天，所有四组患者表现出TNF-α和IL-6的水平增加，并没有在彼此之间就这两种细胞因子的差异。第10天，各组血浆TNF-α和IL-6均下降，A组最低，B组居中，C、D组最高。在第30天，这两种细胞因子没有不同的所有研究groups.Conclusion：血浆TNF-α和IL-6升高AMI后早期下降更快的患者与功能障碍的心肌不仅包括坏死，但也有活力的部分。这种下降被残余缺血的存在所减弱。(c)2004爱思唯尔爱尔兰有限公司保留所有权利。
Background: Proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) can potentiate heart muscle damage during acute myocardial infarction (AMI). Whether changes in their plasma levels after AMI are dependent on the presence of myocardial viability is unclear. The aim of the study was to estimate the relation of time course of plasma TNF-a and IL-6 and the presence of reversible and irreversible myocardial dysfunction in patients early after AMI treated thrombolytically.Material and methods: Patients (54; mean age 60.4 +/- 11.7 years) with AMI plasma TNF-alpha and IL-6 were evaluated on the 2nd, 10th and 30th day after thrombolysis. Based on the response of dysfunctional segments of myocardium during dobutamine stress echocardiography performed on the 10th day, patients were divided into four groups: A, sustained improvement in contractility; B, biphasic (improvement followed by worsening); C, only worsening; D, no change. Twenty-two healthy persons served as controls.Results: On the 2nd day, all four groups of patients demonstrated increased levels of TNF-alpha and IL-6 and did not differ among one another regarding both cytokines. On the 10th day, plasma TNF-alpha and IL-6 decreased in each group and were the lowest in group A, intermediate in group B and the highest in groups C and D. On the 30th day, both cytokines were not different among all studied groups.Conclusion: Elevated plasma TNF-alpha and IL-6 early after AMI decreased more quickly in patients with dysfunctional myocardium comprising not only necrotic but also viable segments. This decline is attenuated by the presence of residual ischemia. (c) 2004 Elsevier Ireland Ltd. All rights reserved.