Platis A, Yu Q, Moore D, Khojeini Ev, Tsau P, Larson Df
Circulatory Sciences Graduate Perfusion Program, College of Medicine, The University of Arizona, Tucson, AZ, USA.
Perfusion. 2008 Jul;23(4):237-42. doi: 10.1177/0267659108101511.
Recently, the cytokine Interleukin-18 (IL-18) has been shown to be increased as a result of cardiac surgery. Elevated IL-18 has been associated with neurological dysfunction, systemic inflammatory response syndrome (SIRS), and multiple organ dysfunction syndrome (MODS) post open-heart surgery. The intent of the study contained herein was to determine the effect of IL-18 administration on cardiac function and structure. Eight C57BL/6 female mice were treated daily with 0.5microg/mouse of recombinant IL-18 for 7 days. Long axis echocardiography (ECHO) measurements of the anatomical and hemodynamic function of the heart for all mice were studied 24h after the last dose. The left ventricular wet weights increased from 84 +/- 1 to 93 +/- 3 mg when comparing the placebo (n = 8) with the IL-18 groups, respectively (p = 0.01). With ECHO analysis, IL-18 significantly increased left ventricular (LV) mass, the left atrium dimensions (LA), and the left ventricular posterior wall thickness (LVPW) over the 8-day time period (p < 0.01). There was a 5-fold increase in interstitial cardiac collagen content and a 30% increase in myocyte size in the IL-18 compared with the control groups (p < 0.01). Administration of IL-18 appears to induce interstitial fibrosis and myocyte hypertrophy, resulting in increased ventricular stiffness. Thus, increased IL-18 during and post open-heart surgical procedures may induce left ventricular diastolic dysfunction and affect post-operative outcomes.
最近研究表明,心脏手术后细胞因子白细胞介素-18(IL-18)水平会升高。升高的IL-18与心脏直视手术后的神经功能障碍、全身炎症反应综合征(SIRS)及多器官功能障碍综合征(MODS)相关。本文所述研究的目的是确定给予IL-18对心脏功能和结构的影响。8只C57BL/6雌性小鼠每天接受0.5μg/只重组IL-18治疗,持续7天。在最后一剂给药24小时后,对所有小鼠进行心脏解剖和血流动力学功能的长轴超声心动图(ECHO)测量。与安慰剂组(n = 8)相比,IL-18组左心室湿重分别从84±1mg增加到93±3mg(p = 0.01)。通过ECHO分析,在8天的时间段内,IL-18显著增加了左心室(LV)质量、左心房内径(LA)和左心室后壁厚度(LVPW)(p < 0.01)。与对照组相比,IL-18组心脏间质胶原含量增加了5倍,心肌细胞大小增加了30%(p < 0.01)。给予IL-18似乎会诱导间质纤维化和心肌细胞肥大,导致心室僵硬度增加。因此,心脏直视手术期间及术后IL-18水平升高可能会诱发左心室舒张功能障碍并影响术后结果。