Patterns and prognostic value of troponin, interleukin-6, and leptin after pediatric open-heart surgery

IntroductionFactors pertaining to religion and spirituality have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle.ObjectivesBased on multidisciplinary literature and previous findings, our study's objectives are to estimate the parallel psychophysiological pathways from pre-operative distress to post-operative depression in patients undergoing open heart surgery.AimsThe study's aims are to examine the association in depression, anxiety, and how coping, spiritual struggle and interleukin-6 play a role in patients following open heart surgery.MethodsPlasma samples for interleukin-6 (IL-6) were obtained before open heart surgery. Patients’ history and demographic information obtained through interviews 2 days before surgery. Follow up interview for mental health and religious were conducted before and after surgery.ResultsThe results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of pre-operative anxiety on post-operative depression. Anxiety had positive indirect effects on post-operative hostility. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle-IL-6 link and maladaptive coping on post-operative mental health attributes.ConclusionsOur study estimated important psychophysiological pathways from pre-operative distress to post-operative maladjustment. To our knowledge, this model is the first analysis to demonstrate the significant mediating effect of the spiritual-IL-6 link, alongside that of positive religious copping and other maladaptive coping, in this population.

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Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial

Cardiology in the Young ◽

10.1017/s1047951115000566 ◽

2015 ◽

Vol 26 (3) ◽

pp. 506-515 ◽

Cited By ~ 13

Author(s):

Muhammad M. Amanullah ◽

Mohammad Hamid ◽

Hashim M. Hanif ◽

Marium Muzaffar ◽

Maria T. Siddiqui ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Interleukin 6 ◽

Heart Surgery ◽

Controlled Trial ◽

Open Heart Surgery ◽

Interleukin 10 ◽

Clinical Parameters ◽

Open Heart ◽

Necrosis Factor Alpha ◽

Randomised Controlled

AbstractBackgroundCardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters.ObjectiveTo assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery.Materials and methodsA randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010–2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines – Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha – were measured. Clinical parameters were also assessed.ResultsBlood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (p<0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p<0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups.ConclusionDexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term.

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Existential Crisis and Behavioral Coping Influence Interleukin-6 Before Open-Heart Surgery

PsycEXTRA Dataset ◽

10.1037/e694422007-001 ◽

2007 ◽

Cited By ~ 1

Author(s):

Amy I. Ai ◽

Ziad Kronfol

Keyword(s):

Interleukin 6 ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Existential Crisis

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Evaluation of Systemic Inflammatory Response in Cardiovascular Surgery via Interleukin-6, Interleukin-8, and Neopterin

The Heart Surgery Forum ◽

10.1532/hsf98.2013267 ◽

2014 ◽

Vol 17 (1) ◽

pp. 13 ◽

Cited By ~ 2

Author(s):

Ihsan Sami Uyar ◽

Suleyman Onal ◽

Ayhan Uysal ◽

Ugur Ozdemir ◽

Oktay Burma ◽

...

Keyword(s):

Inflammatory Response ◽

Valve Replacement ◽

Interleukin 6 ◽

Heart Surgery ◽

Open Heart Surgery ◽

Beating Heart ◽

Systemic Inflammatory Response ◽

The Other ◽

Open Heart ◽

Group 3

Aim: The aim of this study was to evaluate the serum levels of interleukin-6 (IL-6), IL-8, and neopterin as a sign of systemic inflammatory response syndrome after open-heart surgery. In this study, we evaluated the influences on the levels of IL-6, IL-8, and neopterin of coronary artery bypass grafting (CABG) and valve replacement surgeries with and without the use of extracorporeal circulation (ECC).Materials and Methods: This prospective study was performed in 30 patients. In this study, we evaluated patients who underwent valve replacement surgery (group 1, n = 10), CABG with ECC (group 2, n = 10), or CABG using the beating-heart technique (group 3, n = 10). With the Human Investigation Ethics Committee consent, blood samples were obtained from the patients before the surgery (T0) and after 1 hour (T1), 4 hours (T2), 24 hours (T3), and 48 hours (T4) of protamine injection. IL-6, IL-8, and neopterin levels were measured using commercial enzyme-linked immunosorbent assay kits.Results: The demographic data and preoperative and operative characteristics of the patients were similar. Neopterin IL-6 and IL-8 levels significantly increased first at the fourth hour after the surgery. When compared to the levels before the surgery, this increase was statistically significant. Unlike the other 2 groups of patients, those who experienced CABG with the beating-heart technique (group 3) had decreased neopterin levels at the first hour after the surgery, but this decrease was not statistically significant. Neopterin levels increased later in the OPCAB group, but these increased levels were not as high as the neopterin levels of groups 1 and 2. Neopterin reached maximum levels at the 24th hour and, unlike groups 1 and 2, in group started to decrease at the 48th.Conclusions: Complement activation, cytokine production, and related cellular responses are important factors during open-heart surgery. It is certain that ECC activates the complement systems, and activated complement proteins cause the production of several cytokines. In our study, neopterin levels in patients who underwent beating-heart method surgery were lower than those in the other groups, and these levels started to decrease at the 48th hour. These data suggest that the systemic inflammatory response was less activated in that patient group. The beating-heart method might be an important alternative in CABG surgery to minimize the complications and mortality related to surgery.

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