中华医学杂志（英文版）2010，Vol.123Issue(14)：1833-1839,7.DOI:10.3760/cma.j.issn.0366-6999.2010.14.002
Attenuation of tumor necrosis factor-α elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction
Attenuation of tumor necrosis factor-α elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction
LIN Xiang-min 1ZHANG Zhi-yong 1WANG Le-feng 1ZHANG Li 2LIU Yu 1LIU Xiu-lan 1YANG Xin-chun 1CUI Liang 1ZHANG Lin3
作者信息
- 1. Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing 100020, China
- 2. Department of Cardiology, Daqing Oilfield Head Hospital, Daqing,Heilongjiang 163000, China
- 3. Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing 100020, China
- 折叠
摘要
Abstract
Background Postconditioning has been shown to reduce infarct size, ischemic/reperfusion injury and myocardial injury in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). This study tested the hypothesis that postconditioning attenuates the elevation of tumor necrosis factor-α (TNF-α) and improves heart function in patients with AMI after PCI.Methods A total of 75 patients were randomly assigned to 1 of 3 groups: the routine group (n=26), in which no intervention was given at the onset of reperfusion; and the Postcon-30s (n=25) or Postcon-60 s (n=24) groups, in which 3 cycles of 30- or 60-second balloon deflation and inflation were repetitively performed. TNF-α serum concentration was measured by ELISA. Global and regional left ventricular systolic function was determined by echocardiography at 1 year.Thirty-four normal controls (NC) were enrolled in the study.Results The TNF-α concentration in patients with AMI was significantly elevated at baseline compared to controls (P <0.01). Concentration levels increased in the routine and Postcon-30s, but not in Postcon-60s group at 7 days (P <0.05).As for linear associations among the three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) were ranked as follows: Postcon-60s >Postcon-30s>routine (P values all <0.05, 65% vs. 57% vs. 52% and 1.10 vs. 1.27 vs. 1.53) after 1 year. More importantly, there was a significant relevance between the soluble TNF-α serum concentration at 7 days and LVEF or WMSI after 1 year (P values all <0.0001).Conclusions Postconditioning, in particular Postcon-60s was associated with long-term cardioprotective effects for inhibition of the inflammatory response and reperfusion injury. The soluble TNF-α serum concentration provided powerful prognostic information of global and regional left ventricular systolic function in patients with AMI.关键词
left ventricular ejection fraction/wall motion score index/reperfusion injuryKey words
left ventricular ejection fraction/wall motion score index/reperfusion injury引用本文复制引用
LIN Xiang-min,ZHANG Zhi-yong,WANG Le-feng,ZHANG Li,LIU Yu,LIU Xiu-lan,YANG Xin-chun,CUI Liang ,ZHANG Lin..Attenuation of tumor necrosis factor-α elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction [J].中华医学杂志（英文版）,2010,123(14):1833-1839,7.
