ABSTRACT
Background: There are limited data on the complex relationship between metalloproteinases (ММРs) and ischemic heart disease (IHD) in patients with chronic heart failure (CHF). The aim of the study was to investigate the relationship between plasma MMP-9 and IHDif any, as well as the effect of certain clinical and laboratory determinants on that relationship. Methods: The study was conducted on 59 patients with CHF (mean age 69.3 ±7.9), women 42.4%. The total number of definite IHD assessed by angiography was 28. Assessment of the correlations between the investigated variables was done using logistic regression analysis (LRA). Results: MMPs are not significantly higher in ischemic CHF patients [2.4 ±1.7, vs. 1.8 ±0.8 (ng/ml), р>0.05]. The two groups differed significantly in mean values of the left ventricle ejection fraction (LVEF) (36.1±8.6, vs. 46.8±15.7 %), proportion of female gender (21.4 vs. 61.3%) and chronic atrial fibrillation (35.7, vs. 61.3%) found to be lower in IHD group. The number of diabetics is almost fourfold higher in ischemic patients (p<0.05). Significant and independent predictors of ММР-9 are LVEF and etiology (F=2.75, p<0.01). Additionally, in the IHD group the diabetic status independently correlated to the higher plasma MMP-9 (β=0.18, p<0.05).Conclusion: The relationship between ММР-9 and IHD is complex and significantly dependent on diabetes mellitus and the degree of the left ventricle dysfunction, measured by the values of LFEF. The observed relationships in case of DM and LVEF were not observed in the non-ischemic group.
ABSTRACT
Aims: To study the levels of interleukin-8 (IL-8) in patients with paroxysmal atrial fibrillation (occurred in <48 hours) and track the changes after restoration of sinus rhythm. Study Design: Prospective. Place and Duration of Study: The study was conducted in the Intensive Cardiology Department of the First Cardiology Clinic at the University Hospital "St. Marina "- Varna for the period October 2010 – May 2012. Methodology: We included 51 patients (26 men, 25 women; mean age 59.84±1.60 years) with paroxysmal atrial fibrillation and 52 controls (26 men, 26 women; 59.50±1.46 years) with no history of atrial fibrillation. The two groups matched by age, gender and clinical characteristics. Patients’ plasma concentrations of IL-8 were measured three times: immediately after admission to the ward (baseline values), twenty-four hours and twenty-eight days after rhythm restoration. In the control group the indicator was tested once. IL-8 was measured using an ELISA kit. In all patients the arrhythmia episode was discontinued by the administration of propafenone. Results: All patients were hospitalized between the second and the twenty-fourth hour after the onset of the arrhythmia, and most frequently in the fifth hour (10 of all 51 patients). Baseline values of IL-8 were increased compared to those of the controls (77.38±3.78 vs 32.18±1.54 pg/mL, p <0.001). Twenty-four hours after restoration of sinus rhythm, IL-8 concentrations were still significantly higher (65.33±3.29 vs 32.18±1.54 pg/mL, p <0.001). On the twenty-eighth day there was no significant difference (28.07±1.68 vs 32.18±1.54 pg/mL, p = 0.07). Conclusion: Plasma concentrations of IL-8 are significantly elevated in the early hours of the clinical manifestation of paroxysmal atrial fibrillation as well as after the arrhythmia discontinuation. Their restoration occurs slowly over time. The established specific dynamics in IL-8 concentrations suggests a close relationship between paroxysmal atrial fibrillation and inflammation.