Elevated resting and agonist-induced whole blood chemiluminescence in patients with active infective endocarditis

Infective endocarditis (IE) and surgical procedures related to cardiac surgery are accompanied by inflammatory responses that may alter production of oxidants by phagocytes. This study evaluates luminol enhanced whole blood chemiluminescence (LBCL) as a measure of oxidative production by circulating phagocytes in 26 IE patients in comparison to 27 matched patients with acquired valvular heart disease and 25 healthy controls. Blood was collected the day before and 3, 7, 12 and 21 days after valve replacement surgery for LBCL measurement; resting (rCL) and agonist (fMLP)-stimulated total light emission (tCL). Preoperative rCL and tCL with values observed after 3, 7, 14, and 21 days from surgery were higher (P<0.01) in patients with IE than in healthy controls. Median preoperative rCL, and tCL was about 2.5-times higher (P<0.01) in IE group than in patients with valvular heart disease (4.3 vs. 1.7 U/10(4) phagocytes and 2473 vs. 782 Uxs/10(4) phagocytes). Three days after valve replacement, LBCL rose three times (P<0.01) in both operated groups. With patient recovery, LBCL decreased and no differences were noted between groups. Patients with IE had elevated LBCL reflecting increased oxidants release from circulating phagocytes that may predispose to the development of oxidative stress.