Document Detail


Tumor necrosis factor-alpha is associated with early postresuscitation myocardial dysfunction.
MedLine Citation:
PMID:  15286554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Left ventricular dysfunction after successful cardiopulmonary resuscitation contributes to early death following resuscitation. The stress-induced proinflammatory cytokines, particularly tumor necrosis factor-alpha and interleukin-1beta, are known to depress myocardial function. We hypothesized that tumor necrosis factor-alpha and interleukin-1beta, synthesized and released in response to the stress of global ischemia accompanying cardiac arrest, play a role in development of postresuscitation left ventricular dysfunction. METHODS: Hemodynamic variables, tumor necrosis factor-alpha , interleukin-1beta, interleukin-6 (enzyme-linked immunosorbent assay method), and ionized calcium were measured in ten anesthetized swine before and after 7 mins of cardiac arrest and during the early postresuscitation period (60-90 mins). RESULTS: Tumor necrosis factor-alpha increased three-fold within 15 mins of restoration of circulation and remained elevated throughout the observation period. A significant negative correlation was observed between tumor necrosis factor-alpha and left ventricular systolic change in pressure over time (r = -.54, p <.001). Interleukin-1beta was undetectable before and after resuscitation, and interleukin-6 was detectable in only two animals after resuscitation. Although a significant decline in ionized calcium was observed and correlated with left ventricular systolic change in pressure over time, an independent role for ionized calcium in postresuscitation left ventricular dysfunction was not demonstrated. CONCLUSION: Tumor necrosis factor-alpha increases during the early postresuscitation period and may play a role in postresuscitation myocardial dysfunction.
Authors:
James T Niemann; Daniel Garner; Roger J Lewis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  32     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-02     Completed Date:  2004-09-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1753-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Research and Education Institute at Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90509, USA. jniemann@emedharbor.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Calcium / metabolism
Cardiopulmonary Resuscitation / adverse effects*
Cytokines / metabolism
Disease Models, Animal
Female
Hemodynamics / immunology
Ischemia / immunology,  metabolism
Male
Sus scrofa
Tumor Necrosis Factor-alpha / metabolism*
Ventricular Dysfunction, Left / immunology*,  metabolism*,  physiopathology
Chemical
Reg. No./Substance:
0/Cytokines; 0/Tumor Necrosis Factor-alpha; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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