Interleukin-2 as a predictor of early postoperative atrial fibrillation after cardiopulmonary bypass graft (CABG).

Recently, inflammation has been considered as a risk factor of postoperative atrial fibrillation (PAF). The main purpose of this study was to estimate the connections between occurrence of PAF and cytokine release. Thirty-three patients who qualified for cardiopulmonary bypass graft (CABG) were included in the study. Blood was taken from all of them before CABG, then 3 h, 24 h, and 72 h afterwards. Cytokine (IL-6, IL-2, IL-4, IL-10, IFN-gamma, TNF-alpha) concentration was measured at every time point. Eleven patients developed atrial fibrillation after the CABG. Five of them developed PAF until 1 day post-CABG and six of them after 1 day post-CABG. Patients who developed PAF before 1 day post-CABG were characterized by a higher level of IL-2 in sera before 24 h and 72 h post-CABG compared with patients without PAF. Moreover, the PAF before 1 day post-CABG group was also characterized by the higher level of IFN-gamma and IL-10 at 24 h after intervention. Analysis of patients who developed PAF after 1 day post-CABG revealed a higher level of IL-10 and IFN-gamma at 24 h post-CABG compared with patients without PAF. In this study, we have shown for the first time a straightforward connection between IL-2 sera levels and the development of PAF shortly after CABG.

Inflammatory response of coronary artery disease postmenopausal women is associated with the IVS1-397T > C estrogen receptor alpha polymorphism.

We analyzed the relationship between the IVS1-397T > C polymorphism of estrogen receptor alpha gene and inflammatory response of eighty postmenopausal women with an established coronary artery disease (CAD). We found that the IVS1-397T allele carriers exhibited an enhanced inflammatory response in vivo and in vitro. These patients had a higher number of total monocytes and their CD14(+)CD16(+) inflammatory subset in relation to CC homozygotes. The CT and TT women's LPS-stimulated whole blood cell cultures produced more IL6 and TNFalpha than did the cultures of CC women. Moreover, significantly more of the T allele patients had major post-coronary artery bypass grafting complications and less of them experienced subjective angina pectoris improvement. Summarizing, the IVS1-397T > C polymorphism allows us to identify a group of postmenopausal women with the strong inflammatory response which is associated with a higher incidence of the major post-CABG adverse cardiovascular complications.

NK cell compartment in patients with coronary heart disease.

BACKGROUND: Viral and bacterial infections have been considered as a risk factor for Coronary Heart Disease (CHD). NK cells, as a first line of defense against those infections, may play a role in CHD development. Thus, the main aim of our study was to determine NK cell compartment in patients with CHD undergoing coronary artery by-pass grafting. RESULTS: Ninety three patients with CHD were included into the study; the control group consisted of 49 healthy volunteers. As compared to controls, CHD patients had lower NK cytotoxic activity. CHD group had also a decreased absolute number and percentage of total NK cells and CD3-CD56dim cytotoxic NK subset. In addition, we observed tendency toward lower percentage of the CD3-CD56bright regulatory NK subset and CD3-CD56+IFN-gamma+ cells in CHD patients. CONCLUSION: These data indicate that CHD is associated with an impairment of NK cells compartment.

Long-term prognosis after coronary bypass surgery depends on interleukin 6 polymorphism and past acute infections.

We were seeking for a mutual link between the -174G>C IL6 promoter polymorphism, history of the past acute respiratory infections and the long-term post-coronary artery bypass grafting (CABG) major adverse cardiovascular events (MACE) incidence. Two hundred thirty seven post-CABG patients have been followed up for a median period of 36 months. We found that past acute infections, influenza-like illness and lack of vaccination against influenza confer a significant risk of the post-CABG MACE incidence in the -174G allele carrying patients.

Interleukin 6 polymorphism corresponds to the number of severely stenosed coronary arteries.

IL6 gene promoter polymorphisms may influence the outcome of cardiovascular diseases. The aim of our study was to find out whether the -174G>C polymorphism, as well as the IL6 secretory profile, may be linked to the number of severely (> or = 75%) occluded coronary arteries in patients with advanced coronary heart disease (CHD). Three hundred and twenty patients awaiting elective coronary artery bypass grafting were enrolled into the study. Blood was taken the day before surgery. The PCR-RFLP method was used for IL6 gene polymorphism analysis. Spontaneous IL6 release was measured by bioassay in supernatants of whole blood cell cultures (WBCC) incubated for 24 h and 48 h. We found that significantly more patients with triple vessel disease were found within the -174GG group as compared to the -174GC and CC genotype carriers. The highest IL6 serum levels were found in the -174GG and the lowest in the -174CC genotype patients. Spontaneous in vitro IL6 secretion appeared to be significantly higher at all time points in the -174GG as compared to the CC and GC genotype carriers. The serum concentration of IL6 and the spontaneous IL6 secretion were directly related to the number of obstructed coronary vessels. Our results emphasize the role of IL6 as an important, non-classical risk factor predicting the number of severely affected coronary vessels.

High serum interleukin-18 concentrations in patients with coronary artery disease and type 2 diabetes mellitus.

AIMS: The aim of our study was to analyse the serum level of interleukin 18 (IL-18) in coronary artery disease (CAD) patients with type 2 diabetes mellitus (DM), and to relate this to clinical findings. METHODS: The IL-18 level was measured by ELISA in serum samples from 130 CAD patients prior to their first, elective, coronary artery bypass surgery. Forty-three of them had been diabetic for several years. A control group consisted of 31 healthy people matched according to age, BMI, lipid and smoking status. RESULTS: The CAD patients with DM were similar to the non-diabetic CAD patients with respect to age, BMI, grade of heart failure, ejection fraction. There were no differences in the duration of CAD, history of myocardial infarction and PTCA or instability of angina. The serum level of IL-18 was higher in the CAD patients than in the control group. The CAD patients with DM had a higher concentration of IL-18 compared to the non-diabetic CAD group. The diabetic patients with triple-vessel disease were characterized by a higher concentration of IL-18 than the non-diabetic patients with the same grade of CAD. Smoking affected the IL-18 concentration, particularly in the diabetic patients. CONCLUSION: Type 2 DM predisposes patients, especially those with multi-vessel CAD who were smokers, to a higher serum level of IL-18, which may help explain their vulnerability to fatal, secondary cardiovascular events. These patients should be in the first line for stringent, secondary cardiovascular prevention.

Stroke volume variability and heart rate power spectrum in relation to posture changes in healthy subjects.

BACKGROUND: Power spectrum analysis of heart rate variability (HRV) can be used to assess the state of sympathovagal balance-modulating sinus node activity. Stroke volume variability (SVV) probably reflects the dynamics of physiological control mechanisms over time. MATERIAL/METHODS: Power spectrum HRV and SVV were simultaneously measured in 44 healthy men. The values of the HRV and SVV parameters were compared for the supine and upright body positions in three age groups (I: 20-40; II: 40-60; III: >60 years old). The total power (TP) of the very low (VLF:<0.05 Hz), low (LF: 0.05-0.15 Hz) and high (HF: 0.15-0.5 Hz) HRV and SVV frequency bands were measured. The LF/HF and lnLF/lnHF ratios for HRV and SVV were calculated. RESULTS: The upright position caused a significant decrease in HRV in the HF and lnHF bands and an increase in the LF/HF and lnLF/HF ratios in all groups. SVV analysis for the supine position revealed significant differences in lnTP and HF values (between groups I and II) and in lnHF values (between groups I and II and I and III). SVV analysis for the upright position revealed differences in lnTP (between groups I and II and I and III), lnVLF (between groups I and III and I and III), lnLF (between groups I and II and I and III) and lnHF (between groups I and II and I and III). CONCLUSIONS: The combined analysis of HRV and SVV revealed different cardiovascular responses to postural stress in the three age groups considered.

[Intraoperative thermography--temperature range on the heart surface during cold cardioplegia]. / Termografia sródoperacyjna--rozklad temperatur powierzchni serca podczas podawania zimnej kardioplegii.

The paper presents the temperature analysis of the myocardial surface at the cohort of 11 patients with coronary artery disease, who underwent coronary artery bypass grafting with cardiopulmonary bypass. Left and right ventricle temperature changes were registered with Agema Thermovision 900 SW/TE system during cold cardioplegia infusion. Cardioplegia was delivered by the coronary sinus and by the aortic root. An individual pattern of cardioplegia distribution was found. The differences in the temperature of the right and left ventricle correlated with the presence of the critical coronary artery stenosis.