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01-10-2012 | Original Paper

TNF-α, myocardial perfusion and function in patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention

Authors: Eva S. Kehmeier, Wolfgang Lepper, Martina Kropp, Christian Heiss, Ulrike Hendgen-Cotta, Jan Balzer, Mirja Neizel, Christian Meyer, Marc W. Merx, Pablo E. Verde, Christian Ohmann, Gerd Heusch, Malte Kelm, Tienush Rassaf

Published in: Clinical Research in Cardiology | Issue 10/2012

Abstract

Aims

To characterize the time course of tumor necrosis factor-α (TNF-α) serum levels along with myocardial perfusion and contractile function in patients with ST-segment elevation myocardial infarction (STEMI) and successful 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.

Results

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).

Conclusion

Our data reflect the clinical significance of early TNF-α elevation in patients with STEMI and primary PCI (Controlled Clinical Trials number, NCT00529607).

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Title: TNF-α, myocardial perfusion and function in patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention
Authors: Eva S. Kehmeier
Wolfgang Lepper
Martina Kropp
Christian Heiss
Ulrike Hendgen-Cotta
Jan Balzer
Mirja Neizel
Christian Meyer
Marc W. Merx
Pablo E. Verde
Christian Ohmann
Gerd Heusch
Malte Kelm
Tienush Rassaf
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: Clinical Research in Cardiology / Issue 10/2012
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-012-0465-x

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TNF-α, myocardial perfusion and function in patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention

Abstract

Aims

Methods

Results

Conclusion

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Abstract

Aims

Methods

Results

Conclusion

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