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

Dalit Modan-Moses1, Anat Prince, Hannah Kanety

  • 1Pediatric Endocrinology Unit, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel. dmodan@sheba.health.gov.il

Journal of Critical Care
|May 12, 2009
PubMed

Insights

In children undergoing open-heart surgery, leptin levels dropped during cardiopulmonary bypass, while IL-6 and troponin increased. Lower leptin and higher IL-6 correlated with myocardial injury markers.

Area of Science:

  • Pediatric critical care medicine
  • Cardiovascular surgery
  • Biomarker research

Background:

  • Leptin and interleukin-6 (IL-6) are inversely correlated in critically ill patients, impacting survival.
  • Investigating these biomarkers in pediatric cardiac surgery provides insight into perioperative physiological changes.

Purpose of the Study:

  • To examine changes in leptin, IL-6, and troponin levels in children during and after open-heart surgery.
  • To test the hypothesis that IL-6 and troponin increase post-cardiopulmonary bypass (CPB) and correlate inversely with leptin.

Main Methods:

  • Serial blood samples collected from 21 pediatric patients before and up to 48 hours after open-heart surgery.
  • Analysis of leptin, IL-6, and troponin levels in relation to CPB duration and clinical outcomes.

Main Results:

  • Leptin decreased significantly during CPB, then recovered within 12 hours.
  • IL-6 and troponin levels increased during CPB, with IL-6 peaking post-surgery.
  • Negative correlations were observed between leptin and IL-6 (R = -0.448) and between postoperative leptin and troponin (r = -0.535).
  • Lower troponin levels (<20 microg/L) were associated with shorter CPB/aortic clamp times, lower peak IL-6, and reduced need for ventilation/inotropic support.

Conclusions:

  • Postoperative findings indicate lower leptin and higher IL-6 levels correlate with troponin, a marker of myocardial injury.
  • The study suggests leptin's potential cardioprotective role, with its postoperative decline possibly exacerbating myocardial dysfunction.
Abstract

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