Interleukin-6 and tumor necrosis factor alpha in relation to myocardial infarct size and collagen formation

• Published in: Journal of cardiac failure Vol. 9; no. 4; pp. 325 - 332
• Main Authors: Puhakka, Mikko, Magga, Jarkko, Hietakorpi, Seppo, Penttilä, Ilkka, Uusimaa, Paavo, Risteli, Juha, Peuhkurinen, Keijo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2003
• Subjects: Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Area Under Curve; Arrhythmias, Cardiac - blood; Arrhythmias, Cardiac - drug therapy; Arrhythmias, Cardiac - physiopathology; Biomarkers - blood; C-Reactive Protein - drug effects; C-Reactive Protein - metabolism; collagen; Collagen - blood; Collagen - drug effects; Creatine Kinase - drug effects; Creatine Kinase - metabolism; Creatine Kinase, MB Form; cytokines; Electrocardiography; Enalapril - therapeutic use; Female; Finland; Humans; Interleukin-6 - blood; Isoenzymes - drug effects; Isoenzymes - metabolism; Male; myocardial infarction; Myocardial Infarction - blood; Myocardial Infarction - drug therapy; Myocardial Infarction - physiopathology; Peptide Fragments - blood; Peptide Fragments - drug effects; Procollagen - blood; Procollagen - drug effects; Severity of Illness Index; Statistics as Topic; Stroke Volume - drug effects; Tetrahydroisoquinolines - therapeutic use; Time Factors; Treatment Outcome; Trinitrotoluene - blood; Tumor Necrosis Factor-alpha - drug effects; Tumor Necrosis Factor-alpha - metabolism; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - physiopathology; Finland; collagen; cytokines; myocardial infarction
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1054/jcaf.2003.38

Background: Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels increase after acute myocardial infarction (AMI) in humans. Experimental data suggest that these cytokines regulate the initiation of scar formation after AMI. We investigated the interrelationships of IL-6 and TNF-α, tissue injury, infarct size, cardiac function, and collagen formation in humans. Methods: Serum and plasma samples were taken on 93 patients receiving thrombolytic treatment for their first AMI. Collagen formation was evaluated by measuring concentrations of serum aminoterminal propeptide of type III procollagen (PIIINP). Results: IL-6 levels increased by 44% (P <.001) and peaked at 24 hours. Peak IL-6 levels correlated positively with area under the curve of creatine kinase MB mass (r =.31, P <.01), peak troponin T level (r =.34, P <.005), and PIIINP measured at discharge (r =.46, P <.001). There were no changes in TNF-α levels, and patients with left ventricular dysfunction (EF < 40 %) had similar TNF-α levels as those with preserved left ventricular function. Conclusions: IL-6 may regulate collagen formation and thus remodeling of the left ventricle after AMI. In addition, TNF-α measurement is useless in the assessment of infarct size or left ventricular function during the immediate post-infarction period.