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Myocardial proinflammatory cytokine expression and left ventricular remodeling in patients with chronic mitral regurgitation.
- Source :
-
Circulation [Circulation] 2003 Feb 18; Vol. 107 (6), pp. 831-7. - Publication Year :
- 2003
-
Abstract
- Background: In an animal model, stretch was shown to induce myocardial tumor necrosis factor-alpha (TNF-alpha) expression. The purposes of this study were to determine whether the left ventricular (LV) volume overload that occurs in patients with chronic mitral regurgitation (MR) can induce myocardial and systemic TNF-alpha expression and whether there is a relationship between TNF-alpha expression and LV remodeling.<br />Methods and Results: Plasma TNF-alpha and its receptors were measured before mitral valve (MV) repair surgery in 26 MR patients and 23+/-12 months after MV repair surgery in 9 MR patients. Myocardial mRNA copies of TNF-alpha were determined in 11 MR and 10 donor hearts using quantitative RT-PCR. Compared with 15 control subjects, pre-MV repair plasma TNF-alpha (3.59+/-1.81 versus 2.03+/-1.02 pg/mL, P<0.005) and its receptor levels were elevated in MR patients. Myocardial TNF-alpha mRNA copies (corrected for beta-actin mRNA expression) in MR patients and donor hearts were 38.96+/-42.74x10(6) and 0.88+/-0.75x10(6), respectively (P=0.01). After MV surgery, there was a decrease in the plasma levels of TNF-alpha (2.79+/-1.14 versus 3.51+/-1.34 pg/mL, P=0.02) and its receptors. There was a correlation between myocardial TNF-alpha expression and preoperative LV end-diastolic and end-systolic volumes. Moreover, there was an inverse correlation between myocardial TNF-alpha expression and regression in LV end-diastolic (r=-0.76, P=0.007) and end-systolic (r=-0.73, P=0.01) volumes after MV surgery.<br />Conclusions: TNF-alpha is expressed in the myocardium and plasma of MR patients. Correction of the LV volume overload with MV surgery results in reversal of TNF-alpha expression. There is a relationship between TNF-alpha expression and parameters of LV remodeling, suggesting that TNF-alpha may play a role in the pathogenesis of the LV remodeling that occurs in MR.
- Subjects :
- Adult
Aged
Antigens, CD blood
Biopsy
Chronic Disease
Cytokines analysis
Cytokines genetics
Female
Hemodynamics
Humans
Interleukin-6 blood
Male
Middle Aged
Mitral Valve surgery
Mitral Valve Insufficiency surgery
Myocardium chemistry
Postoperative Period
RNA, Messenger metabolism
Receptors, Interleukin-6 blood
Receptors, Tumor Necrosis Factor blood
Receptors, Tumor Necrosis Factor, Type I
Receptors, Tumor Necrosis Factor, Type II
Reference Values
Severity of Illness Index
Tumor Necrosis Factor-alpha analysis
Tumor Necrosis Factor-alpha genetics
Cytokines metabolism
Mitral Valve Insufficiency physiopathology
Myocardium metabolism
Tumor Necrosis Factor-alpha metabolism
Ventricular Remodeling
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4539
- Volume :
- 107
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 12591752
- Full Text :
- https://doi.org/10.1161/01.cir.0000049745.38594.6d