TROPONIN-I AND MACROPHAGE MIGRATION INHIBITORY FACTOR (MIF) LEVELS IN THE PERICARDIAL FLUID (PF) COULD BE EARLY INDICATORS OF MYOCARDIAL INJURY/ISCHEMIA AND PROINFLAMMATION
Abstract number: O44
Aims:
To test the hypothesis that the composition of PF reflects the pathophysiological changes in the cardiac muscle due to coronary heart disease, such as hypoxia/ischemia and pro-inflammation.
Methods:
Serum and PF samples were collected before coronary artery bypass graft(CABG, n=23) and valve replacement (VR, n=13) surgery and their contents were analyzed.
Results:
In the PF of CABG and VR, phosphate, lactate, creatinin-kinase, LDH, albumin and protein content and renin activity were significantly decreased (p<0.05) compared to those of serum levels and activity. Protein contents were: in CABG-PF: 16.7±1.6mmol/L, CABG-serum: 44.8±2.5mmol/L, VR-PF: 20.5±2.4mmol/L, and VR-serum: 41±2.9mmol/L, p<0.05. LDH levels: in CABG-PF: 48.2±10.6U/L, in CABG-serum: 186.3±11.8U/L; in VR-PF 56±14.5U/L, in VR-serum: 184.5±17.3U/L, p<0.05. Creatinin-kinase were: in CABG-PF 4.17±0.9U/L, in CABG-serum: 40.2±3.5U/L, in VR-PF: 5.2±1.3U/L, in VR-serum: 65.2±28.05U/L, p<0.05. Renin activities were: in CABG-PF: 0.17±0.2ng/mL/h, in CABG-serum: 23.8±7.5ng/mL/h, in VR-PF: 0.04±0.02ng/mL/h, in VR-serum: 10.4±4.4ng/mL/h, p<0.05. Serum troponin-I levels were below the ischemic level (<40pg/mL) in both VR and in CABG patients. PF troponin-I levels were significantly higher both in CABG and VR patient than the serum levels. The levels of MIF were: in CABG-PF: 32.6±4.6ng/mL, in CABG-serum: 3.9±0.5ng/mL, in VR-PF: 16.5±3.8ng/mL, in VR-serum: 3.8±0.9ng/mL, p<0.05. The MIF level of PF was significantly higher in CABG and VR patients than that of serum. The MIF level of PF was significantly higher in CABG than in VR patients.
Conclusion:
Among others, these results suggest that 1) the troponin-I level in the PF is a more sensitive marker of ischemia than that of serum, 2) in CABG and VR patients a higher level of troponin-I in PF could indicate progressed myocardial injury/ischemia. Also, the higher MIF level in PF, especially in CABG, could be an early indicator of proinflammation.
Support:
AHA-FA 0855910D, Hungarian Sci. Res. Funds/OTKA K71591 and K67984.