Neurohormonal and cytokine fluctuations following transcatheter closure for an atrial septal defect

被引:7
作者
Chamakou, Aikaterini C. [1 ]
Dede, Eleni [1 ]
Moutafi, Antonia [1 ]
Thanopoulos, Vassileios [2 ]
Chryssanthopoulos, Stavros [1 ]
Loukopoulou, Sophia [2 ]
Pitsavos, Christos [3 ]
Stefanadis, Christodoulos [3 ]
Davos, Constantinos H. [1 ]
机构
[1] Acad Athens, Biomed Res Fdn, Cardiovasc Res Lab, Athens 11527, Greece
[2] Aghia Sophia Childrens Hosp, Dept Paediat Cardiol, Athens 11527, Greece
[3] Univ Athens, Hippokration Gen Hosp, Dept Cardiol 1, Athens 11527, Greece
关键词
Atrial septal defect; Inflammation; Amplatzer; NATRIURETIC-PEPTIDE; HEART-FAILURE; ADULT; DISEASE; INDEX;
D O I
10.1016/j.cyto.2011.10.002
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Introduction: Inflammation and neurohormonal activation are considered to be involved in the development of earlier and/or later complications in congenital heart disease patients, even after a successful repair of the lesion. It is not yet clarified what is the role of the therapeutic interventions in the occurrence of such a response and how it could be associated with possible postoperative complications. Aim: We sought to assess the inflammatory and neurohormonal response to transcatheter closure of secundum type atrial septal defects (ASD) over a six-month follow-up period. We also evaluated the association between the respective markers and catheterization data as well as echocardiographic measurements. Methods: Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10), N-terminal-proatrial natriuretic peptide (NT-proANP) and N-terminal-probrain natriuretic peptide (NT-proBNP) were assessed and echocardiographic measurements were performed in twenty-eight patients with atrial septal defect prior to, and at the first, second and sixth months post transcatheter closure. Thirty-three age-matched healthy volunteers were also enrolled. Results: IL-6 plasma levels, although higher preoperatively, [physical logarithm (In) IL-6: 3.37 +/- 0.66 vs 2.92 +/- 0.44 pg/ml, p = 0.015], reached control levels postoperatively, at the end of the third month, whereas TNF-alpha, and IL-10 were not influenced by the procedure. NT-proANP levels were elevated preoperatively compared to the control group (In NT-proANP 3.78 +/- 0.572 vs 3.48 +/- 0.30, p = 0.031), with a further significant increase during the 1st month (In NT-proANP 3.78 +/- 0.572 vs 4.2 +/- 0.42, p = 0.006), following the pattern of the left atrial volume enlargement, and remained high even 6 months after the procedure On the other hand, the initially normal concentrations of NT-proBNP, after a transient significant increase during the first month postoperatively (In NT-proBNP 3.56 +/- 0.94 vs 4.58 +/- 0.91, p < 0.0001) returned to the controls' levels at the end of the third month. Preoperative concentrations of NT-proANP positively correlated with NT-proBNP concentrations and pulmonary to systemic flow ratio (QP/Qs). Conclusions: Transcatheter closure could improve, on a mid- term basis, the inflammatory process but natriuretic peptides' secretion continues in parallel with left atrial volume increase. Further follow up is required to determine the long-term progress of the inflammatory and neurohormonal response to the procedure. (C) 2011 Elsevier Ltd. All rights reserved.
引用
收藏
页码:130 / 135
页数:6
相关论文
共 32 条
[1]   A glossary of circulating cytokines in chronic heart failure [J].
Adamopoulos, S ;
Parissis, JT ;
Kremastinos, DT .
EUROPEAN JOURNAL OF HEART FAILURE, 2001, 3 (05) :517-526
[2]   Erosion of amplatzer septal occluder device after closure of secundum atrial septal defects: Review of registry of complications and recommendations to minimize future risk [J].
Amin, Z ;
Hijazi, ZM ;
Bass, JL ;
Cheatham, JP ;
Hellenbrand, WE ;
Kleinman, CS .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2004, 63 (04) :496-502
[3]   Congenital heart disease: the original heart failure syndrome [J].
Bolger, AP ;
Coats, AJS ;
Gatzoulis, MA .
EUROPEAN HEART JOURNAL, 2003, 24 (10) :970-976
[4]   Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease [J].
Bolger, AP ;
Sharma, R ;
Li, W ;
Leenarts, M ;
Kalra, PR ;
Kemp, M ;
Coats, AJS ;
Anker, SD ;
Gatzoulis, MA .
CIRCULATION, 2002, 106 (01) :92-99
[5]   Inflammatory markers and cardiovascular disease (The Health, Aging and Body Composition [Health ABC] Study) [J].
Cesari, M ;
Penninx, BWJH ;
Newman, AB ;
Kritchevsky, SB ;
Nicklas, BJ ;
Sutton-Tyrrell, K ;
Tracy, RP ;
Rubin, SM ;
Harris, TB ;
Pahor, M .
AMERICAN JOURNAL OF CARDIOLOGY, 2003, 92 (05) :522-528
[6]  
Daniels LMaiselA, 2007, J AM COLL CARDIOL, P50
[7]  
Dardas PS, 2010, HELL J CARDIOL, V51, P104
[8]   Serum Levels of Natriuretic Peptides in Children before and after Treatment for an Atrial Septal Defect, a Patent Ductus Arteriosus, and a Coarctation of the Aorta-A Prospective Study [J].
Eerola, Anneli ;
Jokinen, Eero ;
Boldt, Talvikki ;
Mattila, Ilkka P. ;
Pihkala, Jaana I. .
INTERNATIONAL JOURNAL OF PEDIATRICS, 2010, 2010
[9]  
El-Menyar A, 2008, J CARD FAIL, V14, P89
[10]   Usefulness of Natriuretic Peptide Levels to Predict Mortality in Adults With Congenital Heart Disease [J].
Giannakoulas, Georgios ;
Dimopoulos, Konstantinos ;
Bolger, Aidan P. ;
Tay, Edgar Lik ;
Inuzuka, Ryo ;
Bedard, Elisabeth ;
Davos, Constantinos ;
Swan, Lorna ;
Gatzoulis, Michael A. .
AMERICAN JOURNAL OF CARDIOLOGY, 2010, 105 (06) :869-873