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首页> 外文期刊>Cytokine >Role of proinflammatory markers and NT-proBNP in patients with an implantable cardioverter-defibrillator and an electrical storm.
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Role of proinflammatory markers and NT-proBNP in patients with an implantable cardioverter-defibrillator and an electrical storm.

机译：促炎标记物和NT-proBNP在植入式心脏复律除颤器和电风暴患者中的作用。

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BACKGROUND: Several studies have attempted to identify risk factors for the development of an electrical storm (ES), which is defined as 3 separate ventricular tachyarrhythmic (VT/VF) events, but in the majority of studies no triggers have been found. However, little is known about the role of inflammation and NT-proBNP in patients with ES. The aim of this study was therefore to assess the relationship of Interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and NT-proBNP serum concentrations in ICD-patients with or without single spontaneous ventricular tachyarrhythmic events (VT/VF) and in ES. METHODS: Markers were determined in 51 patients without ICD-intervention, in 15 ICD-patients with single VT/VF-episodes during 9-months follow-up and in 20 ICD-patients with ES (blood sampling performed within 60min after fulfilling ES criteria). VT/VF-episodes were analysed by stored ICD-electrograms. RESULTS: All patients had idiopathic dilated cardiomyopathy (n=23) or coronary artery disease (n=63). Patients with ES revealed significantly higher mean serum concentrations of all markers (IL-6 15.19+/-10.34 pg/mL, hs-CRP 20.12+/-14.4 mg/L, NT-proBNP 4799+/-4596 pg/mL) compared to baseline values of patients with single VT/VF-events during follow-up (IL-6 8.37+/-5.8 pg/mL (p=0.03), hs-CRP 4.7+/-5.3 mg/dL (p<0.001), NT-proBNP 1913+/-2665pg/mL (p=0.04)) and compared to baseline values of ICD-patients without device intervention (IL-6 4.62+/-3.66 pg/mL (p<0.001), hs-CRP 4.1+/-3.4 mg/L (p<0.001), NT-proBNP 1461+/-2281pg/mL (p<0.001)). In 9/20 patients presenting with ES (45%) baseline values were available. All markers were significantly higher during ES compared to event-free determination (IL-6 14.54+/-10.43 vs. 7.03+/-2.83 pg/mL (p=0.04), hs-CRP 19.07+/-16.07 vs. 6.5+/-3.9 mg/L (p=0.02), NT-proBNP 4218+/-2561 vs. 2099+/-1279 pg/mL (p=0.03)). CONCLUSIONS: Electrical storm is associated with significantly elevated IL-6, hs-CRP and NT-proBNP serum concentrations in ICD-patients with structural heart disease. Thus, ES may be triggered by proinflammatory activity. Combined intraindividual elevation of determined markers might help to identify patients at risk of impending electrical storm.
机译：背景：数项研究已尝试确定发展为电风暴（ES）的危险因素，电暴定义为3个独立的室性心律失常（VT / VF）事件，但在大多数研究中均未发现任何诱因。然而，关于炎症和NT-proBNP在ES患者中的作用知之甚少。因此，本研究的目的是评估有无单发自发性心律失常的ICD患者的白细胞介素6（IL-6），高敏C反应蛋白（hs-CRP）和NT-proBNP血清浓度之间的关系。事件（VT / VF）和ES中。方法：确定了51例无ICD干预的患者，15例在9个月的随访中有单发VT / VF发作的ICD患者和20例ES的ICD患者（符合ES标准后60分钟内进行血液采样）的标志物）。 VT / VF发作通过存储的ICD电泳图进行分析。结果：所有患者均患有特发性扩张型心肌病（n = 23）或冠心病（n = 63）。 ES患者显示所有标志物的平均血清浓度均显着较高（IL-6 15.19 +/- 10.34 pg / mL，hs-CRP 20.12 +/- 14.4 mg / L，NT-proBNP 4799 +/- 4596 pg / mL）随访期间发生单次VT / VF事件的患者的基线值（IL-6 8.37 +/- 5.8 pg / mL（p = 0.03），hs-CRP 4.7 +/- 5.3 mg / dL（p <0.001） ，NT-proBNP 1913 +/- 2665pg / mL（p = 0.04））并与未经设备干预的ICD患者基线值进行比较（IL-6 4.62 +/- 3.66 pg / mL（p <0.001），hs-CRP 4.1 +/- 3.4 mg / L（p <0.001），NT-proBNP 1461 +/- 2281pg / mL（p <0.001））。 9/20表现为ES（45％）基线值的患者可用。与无事件测定相比，ES期间所有标志物均显着更高（IL-6 14.54 +/- 10.43 vs. 7.03 +/- 2.83 pg / mL（p = 0.04），hs-CRP 19.07 +/- 16.07 vs. 6.5+ /-3.9 mg / L（p = 0.02），NT-proBNP 4218 +/- 2561与2099 +/- 1279 pg / mL（p = 0.03））。结论：结构性心脏病的ICD患者中，电风暴与IL-6，hs-CRP和NT-proBNP血清浓度显着升高有关。因此，ES可能由促炎活性触发。结合使用确定的标记物进行个体化抬高可能有助于识别有即将发生雷暴的风险的患者。

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