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Expresión cuantitativa de citoquinas miocárdicas y activación de la vía apoptótica en pacientes que requieren
1National Heart and Lung Institute at Imperial College School of Medicine, Royal Brompton and Harefield Hospital, Harefield, Middlesex.
Circulation
|September 25, 2001
Resumen
Los pacientes con insuficiencia cardíaca en deterioro que necesitan dispositivos de asistencia de LV (LVAD) muestran un aumento de las citoquinas inflamatorias factor de necrosis tumoral-alfa (TNF-alfa), interleucina-1beta (IL-1beta) e IL-6. Estos cambios moleculares en el miocardio y el suero pueden afectar el tiempo y los resultados del tratamiento con LVAD.
Área de la Ciencia:
- Cardiología Cardiología.
- Inmunología Inmunología.
- Biología Molecular Biología Molecular
Sus antecedentes:
- Los mecanismos de deterioro del paciente durante la implantación del dispositivo de asistencia de LV (LVAD) no se comprenden completamente.
- Investigar las citoquinas inflamatorias y las vías apoptóticas en la insuficiencia cardíaca avanzada es crucial.
Objetivo del estudio:
- Para comparar los marcadores inflamatorios y la activación de la vía apoptótica en pacientes que requieren apoyo LVAD frente a los que se someten a un trasplante de corazón electivo.
- Para dilucidar las diferencias moleculares en el deterioro de los pacientes con insuficiencia cardíaca.
Principales métodos:
- Análisis de muestras de miocardio y suero de pacientes con LVAD y receptores de trasplante de corazón.
- Medición de los niveles de factor de necrosis tumoral alfa (TNF-alfa), interleucina-1beta (IL-1beta) e IL-6 en el ARNm y las proteínas.
- Evaluación de los marcadores de la vía apoptótica, incluidos los caspases y el DFF-45.
Principales resultados:
- Los pacientes con LVAD mostraron elevados niveles de TNF-alfa, IL-6 e IL-1beta mRNA y proteínas en el miocardio.
- Los niveles séricos de TNF-alfa e IL-6 fueron significativamente más altos en pacientes con LVAD.
- Los componentes de la vía apoptótica como la procaspasa-9 y la caspasa-9 escindida se incrementaron en pacientes con LVAD.
Conclusiones:
- Los pacientes con insuficiencia cardíaca en deterioro que requieren apoyo LVAD muestran un aumento de las citoquinas inflamatorias miocárdicas y séricas (TNF-alfa, IL-1beta, IL-6).
- Las alteraciones en la vía apoptótica están presentes en estos pacientes.
- Los hallazgos sugieren posibles implicaciones terapéuticas e influyen en el momento óptimo para la inserción de LVAD.
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