Journal article
Concomitant elevated serum levels of tenascin, MMP-9 and YKL-40, suggest ongoing remodeling of the heart up to 3 months after cardiac surgery after normalization of the revascularization markers
EUROPEAN JOURNAL OF MEDICAL RESEARCH, v 27(1), 208
21 Oct 2022
PMID: 36271425
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background The recovery from cardiac surgery involves resolving inflammation and remodeling with significant connective tissue turnover. Dynamics of smoldering inflammation and injury (white blood cells, platelets, CRP, IL-8, IL-6), vascular inflammation (IL-15, VEGF, RANTES), connective tissue remodeling (tenascin, MMP-9), cardiac injury and remodeling (YKL-40), and vascular remodeling (epiregulin, MCP-1, VEGF) were assessed up to 3 months after cardiac surgery. We hypothesize that at 3 months, studied markers will return to pre-surgical levels. Methods Patients (n = 139) scheduled for non-emergent heart surgery were included, except for patients with pre-existing immunological aberrancies. Blood was collected before surgery(t(baseline)), 24 h later(t(24h)) after the first sample, 7 days(t(7d)), and 3 months(t(3m)) after t(baseline). Serum markers were measured via multiplex or ELISA. Electronic medical records (EMR) were used to extract demographical, pre-existing conditions and clinical data. Disposition (discharge home, discharge to facility, death, re-admission) was determined at 28 days and 3 months from admission. Results Not all inflammatory markers returned to baseline (CRP up arrow up arrow, leukocytosis, thrombocytosis, IL-8 down arrow, IL-6 down arrow). Tenascin and YKL-40 levels remained elevated even at t(3m). YKL-40 serum levels were significantly elevated at t(24h) and t(7d) while normalized at t(3m). VEGF returned to the baseline, yet MCP-1 remained elevated at 3 months. CCL28 increased at 3 months, while RANTES and IL-15 declined at the same time. Disposition at discharge was determined by serum MMP-9, while YKL-40 correlated with duration of surgery and APACHE II24h. Conclusions The data demonstrated an ongoing extracellular matrix turnover at 3 months, while acute inflammation and vascular remodeling resolved only partially.
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Details
- Title
- Concomitant elevated serum levels of tenascin, MMP-9 and YKL-40, suggest ongoing remodeling of the heart up to 3 months after cardiac surgery after normalization of the revascularization markers
- Publication Details
- EUROPEAN JOURNAL OF MEDICAL RESEARCH, v 27(1), 208
- Publisher
- BMC; LONDON
- Grant note
- This grant was funded through Alzheimer's Disease Core Center (National Institutes of Health-National Institute on Aging), P30 AG10124, NIGMS NIH K23 GM120630 and KL's own funds.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000871039200002
- Scopus ID
- 2-s2.0-85140205456
- Other Identifier
- 991021860733204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Medicine, Research & Experimental