Time-dependent changes of plasma inflammatory biomarkers in type A aortic dissection patients without optimal medical management

Journal of Cardiothoracic Surgery

Wei Meng¹  Ying-kang Shi¹  Er-yong Zhang¹  Ying-qiang Guo¹  Ming-hua Zhong¹  Hong Qian¹  Zhi Fang¹  Zheng-hua Xiao¹  Hong-wei Zhang¹  Jia Hu¹  Jun Gu¹ 

[1] Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du 610041, Sichuan, People’s Republic of China

关键词: Complication;    Tumor necrosis factor-α;    C-reactive protein;    Interleukin-6;    Inflammatory mediator;    Type A aortic dissection;   

Others  :  1136022
DOI  :  10.1186/s13019-014-0199-0

 received in 2014-06-09, accepted in 2014-12-26,  发布年份 2015

【 摘 要 】

Objectives

To investigate the time-dependent changes in plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α in patients with type A aortic dissection (TAAD) who received unoptimal medical management since the onset of dissections.

Design and methods

Plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α were detected by ELISA and immuno-turbidimetric assay in 92 TAAD patients at hospital admission. Blood samples from 78 patients with uncontrolled hypertension and 82 healthy volunteers were also analyzed as controls. The occurrence of TAAD-related complication and its relationship with the plasma levels of these inflammatory biomarkers was also investigated.

Results

The concentrations of inflammatory mediators were significant higher in TAAD than those in the uncontrolled hypertension and the healthy group. The time to peak plasma level of IL-6.and TNF-α was shorter than that of CRP in TAAD group. In the TAAD group, 51 patients suffered TAAD-related complications, and their plasma level of CRP was significantly higher than that in patients without TAAD-related complications (94.5 ± 58.8 mg/L versus 47.4 ± 47.8 mg/L, p < 0.001). Also, CRP levels strongly correlated with the value of PaO₂/FiO₂ ratio (r = −0.69, p < 0.001) and creatinine (r = 0.60, p < 0.001). The time to the peak level of CRP was shorter and the duration of persistently high CRP level was longer in the complication group than those in the complication-free group.

Conclusions

Elevated and persistently high levels of plasma CRP, IL-6 and TNF-α were associated with progressively development of the TAAD. The changing pattern of CRP might be a marker for diagnosis and prophylactic treatment of complications. Our findings suggested a critical role of the inflammation in the progression of dissection and TAAD-related complications.

【 授权许可】

   
2015 Gu et al.; licensee BioMed Central.

【 图 表 】

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