TNF-α, myocardial perfusion and function in patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention
Clinical Research in Cardiology, 05/21/2012
Kehmeier ES et al. – This data reflect the clinical significance of early TNF–α elevation in patients with ST–segment elevation myocardial infarction (STEMI) and primary percutaneous coronary intervention (PCI).Methods
- Serum levels of TNF– α, interleukin 6 (IL–6), and C–reactive protein (CRP) were measured in 42 patients with STEMI before, one and 6 days after successful PCI.
- Myocardial perfusion was assessed by contrast–enhanced echocardiography (ceEcho), contractile function by unenhanced two–dimensional (2DE) and real–time three–dimensional echocardiography.
- In a subset of 18 patients, infarct size was quantified by late gadolinium enhancement cardiovascular magnetic resonance imaging (LGE–CMR) on day six.
- TNF– α serum levels were in the upper normal range within the first 12 h from symptom onset and increased continuously until day six, while IL–6 and CRP increased subsequently with a peak on day one after STEMI.
- Serum TNF– α on day one after PCI correlated with perfusion defects, wall motion abnormalities, and infarct size (ceEcho: r = 0.52, p = 0.005; 2DE: r = 0.56, p = 0.002; LGE–CMR: r = 0.83–0.86; p < 0.0001).
- Using multiple regression linear analysis, infarct size on day six was predicted by serum TNF– α 1 day after PCI (p = 0.006, adjusted R 2 0.638).