TY - JOUR
T1 - Patterns and prognostic value of troponin, interleukin-6, and leptin after pediatric open-heart surgery
AU - Modan-Moses, Dalit
AU - Prince, Anat
AU - Kanety, Hannah
AU - Pariente, Clara
AU - Dagan, Ovdi
AU - Roller, Milton
AU - Vishne, Tali
AU - Efrati, Ori
AU - Paret, Gideon
PY - 2009/9
Y1 - 2009/9
N2 - Purpose: Leptin and interleukin-6 (IL-6) are inversely correlated and associated with decreased survival in critically ill patients. We investigated changes in leptin, IL-6, and troponin in children undergoing open-heart surgery, hypothesizing that IL-6 and troponin will increase after cardiopulmonary bypass (CPB) and will be negatively correlated with leptin. Patients and Methods: Serial blood samples were collected from 21 patients 24 hours before and up to 48 hours after surgery. Results: Leptin levels decreased by 50% during CPB (P < .001), then gradually increased, reaching baseline levels 12 hours after surgery. The IL-6 levels increased (P < .001) during CPB, peaking 2 hours after surgery and remaining slightly elevated at 24 hours after surgery (P < .001). Leptin and IL-6 were negatively correlated (R = -0.448, P < .001). Troponin levels increased during CPB (P < .001). Postoperative leptin and troponin were inversely correlated (r = -0.535, P < .001). Patients with modest elevations in troponin levels (<20 μg/L) had a shorter aortic clamp and CPB time (P < .01), lower IL-6 peak levels (P = .03), and shorter duration of ventilation and inotropic support compared with patients with peak troponin levels greater than 20 μg/L. Conclusions: Lower leptin and higher IL-6 levels correlated with troponin, a marker of myocardial injury. Because leptin may have cardioprotective effects, the postoperative drop in its levels may further contribute to myocardial dysfunction.
AB - Purpose: Leptin and interleukin-6 (IL-6) are inversely correlated and associated with decreased survival in critically ill patients. We investigated changes in leptin, IL-6, and troponin in children undergoing open-heart surgery, hypothesizing that IL-6 and troponin will increase after cardiopulmonary bypass (CPB) and will be negatively correlated with leptin. Patients and Methods: Serial blood samples were collected from 21 patients 24 hours before and up to 48 hours after surgery. Results: Leptin levels decreased by 50% during CPB (P < .001), then gradually increased, reaching baseline levels 12 hours after surgery. The IL-6 levels increased (P < .001) during CPB, peaking 2 hours after surgery and remaining slightly elevated at 24 hours after surgery (P < .001). Leptin and IL-6 were negatively correlated (R = -0.448, P < .001). Troponin levels increased during CPB (P < .001). Postoperative leptin and troponin were inversely correlated (r = -0.535, P < .001). Patients with modest elevations in troponin levels (<20 μg/L) had a shorter aortic clamp and CPB time (P < .01), lower IL-6 peak levels (P = .03), and shorter duration of ventilation and inotropic support compared with patients with peak troponin levels greater than 20 μg/L. Conclusions: Lower leptin and higher IL-6 levels correlated with troponin, a marker of myocardial injury. Because leptin may have cardioprotective effects, the postoperative drop in its levels may further contribute to myocardial dysfunction.
KW - Cardiopulmonary bypass
KW - IL-6
KW - Leptin
KW - Myocardial injury
KW - Troponin
UR - http://www.scopus.com/inward/record.url?scp=68049120203&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2009.02.011
DO - 10.1016/j.jcrc.2009.02.011
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C2 - 19427762
AN - SCOPUS:68049120203
SN - 0883-9441
VL - 24
SP - 419
EP - 425
JO - Journal of Critical Care
JF - Journal of Critical Care
IS - 3
ER -