Tumor Necrosis Factor - alpha in Clinical Manifestation of Paroxysmal Atrial Fibrillation

Въведение: Предсърдното мъждене (ПМ) е най-честата аритмия в клиничната практика. Все повече данни се натрупват за участието на цитокините в патогенезата на аритмията, като обект на изследване до момента са преди персистиращата и перманентната форма на ритъмното нарушение.Цел: Да се потърсят промени в плазмените концентрации на TNF-α, свързани с изявата на пароксизмалното предсърдно мъждене (ППМ).Материал и методи: Плазмените концентрации на TNF-α бяха измерени трикратно при 51 пациенти (26 мъже и 25 жени; средна възраст 59.84 1.60 г) с ППМ, a именно: незабавно след хоспитализацията им (т.е. по време на ритъмното нарушение), 24 часа и 28 дни след възстановяване на синусов ритъм. Показателят беше измерен еднократно при 52 контроли (26 мъже и 26 жени; средна възраст 59.50 1.46 г.) без анамнестични или електрокардиографски данни за ПМ до момента. Плазмените концентрации на TNF-α бяха определени с ELISA кит (Elabscience Biotechnology Co., Ltd, China). Синусов ритъм бе възстановен медикаментозно с propafenone.Резултати: При постъпване на пациентите в отделението концентрациите на TNF-α бяха повишени спрямо тези на контролите (15.06 0.81 vs 8.20 0.29 pg/mL, p<0.001). Двадесет и четири часа след възстановяване на синусов ритъм промените персистираха (13.09 0.70 vs 8.20 0.29 pg/mL, p<0.001). На двадесет и осмия ден липсваше значима разлика (9.21 0.54 vs 8.20 0.29 pg/mL, p=0.10).Заключение: При ППМ се наблюдават динамични промени в плазмените концентрации на TNF-α. Те са значимо повишени по време на клиничната изява на ритъмното нарушение. След възстановяване на синусов ритъм те се нормализират бавно във времето. Специфичният характер на установените отклонения дават сериозно основание да се приеме клиничната им значимост за изявата на заболяването.Introduction: Atrial fibrillation is the most common arrhythmia in clinical practice. There has been a growing body of evidence in recent years of the role of inflammatory cytokines in the pathogenesis of the rhythm disorder, although the studies have been predominantly in the field of persistent and permanent atrial fibrillation. Aim: To find changes in plasma concentrations of TNF-α, concerning the clinical manifestation of paroxysmal atrial fibrillation. Materials and Methods: Plasma concentrations of IL-6 were measured three times in 51 patients (26 men and 25 women; mean age 59.84 1.60 yrs) with paroxysmal atrial fibrillation: once immediately after hospitalization of these patients (that is, during the rhythm disorder episode at baseline), then at 24 hours and finally 28 days after restoration of sinus rhythm. The plasma concentration was measured only once in the control group of 52 control subjects (26 men, 26 women; mean age 59.50 1.46 yrs). We used ELISA kit to determine the IL-6 concentrations. The sinus rhythm was restored with propafenone for all patients. Results: Baseline plasma concentrations of IL-6 were higher than those of controls (15.06.38 0.81 vs 8.20 0.29 pg/mL, p<0.001). The difference was retained for 24 hours after sinus rhythm restoration of (13.09 0.70 vs 8.20 0.29 pg/mL, p<0.001). At 28 days there was no statistically significant difference between patients and controls (9.21 0.54 vs 8.20 0.29 pg/mL, p=0.10). Conclusion: Dynamic changes of TNF-α plasma concentrations were established in paroxysmal atrial fibrillation. The cytokine levels were significantly elevated during the clinical manifestation of the arrhythmia. They decreased slowly after restoration of sinus rhythm. The changes we found provide a strong rationale to suggest that they are most likely relevant to the clinical manifestaton of paroxysmal atrial fibrillation

Dynamics of oxidative status in patients with paroxysmal atrial fibrillation

Introduction: Studies have established oxidative disorders in persistent and permanent atrial fibrillation. Our aim was to investigate oxidative status still in the early hours of paroxysmal atrial fibrillation (PAF) and monitor its changes after sinus rhythm (SR) restoration. Material and Methods: Levels of malondialdehyde and total glutathione were determined in plasma (Pl-MDA; Pl-GSH) and erythrocytes (Er-MDA; Er-GSH) together with erythrocyte glutathione peroxidase activity (GSH-Px) in 51 patients (59.84±1.6 years, 26 males). Markers were investigated upon hospital admission, 24 hours and 28 days after SR restoration. They were also determined in 52 healthy subjects (59.50±1.46 years, 26 males). Results: Mean AF duration prior to hospitalization was 8.14±0.76 hours. Upon admission, Pl-MDA and Er-MDA were significantly increased (p0.05). Conclusion: Disorder of oxidative status is detected in the early hours of PAF, which persists after SR restoration. Oxidative balance is restored slowly with time. This specific dynamics of oxidative status is most likely related to AF clinical course, namely to its manifestation and recurrences

Influence of air pollution in an urban area on hospital admissions from acute myocardial infarction

It has been established that the episodes of huge atmospheric pollutions like the London fog of 1952 are responsible for an increased mortality, the larger part of which from cardiovascular events. Aim of the study is to investigate the relation between the levels of atmospheric pollutants and the frequency of hospital admissions from acute myocardial infarction (AMI) in the city of Varna. Five hundred and eighty five patients were investigated from those who were admitted to the Intensive Care Clinic of St Marina University Hospital in Varna with a diagnosis of acute myocardial infarction (AMI) in the period from December 2004 to December 2005. For the same period from October 2004 to December 2005 the relationship between the quality of the atmospheric air and the frequency of hospital admissions form AMI was investigated. For the investigated period from 1 October 2004 to 31 December 2005 a total of 585 persons were admitted for treatment at the ICC with a diagnosis of AMI, of which 393 (67.2%) were men and 192 (32.8%) were women. The mean age for them was 64.05 ± 0.49 years (from 18 to 93 years of age). The frequency of hospital admissions from AMI show sta tis ti cally sig nif i cant correlational sub or di na tions with al most all stud ied at mo spheric pol lut ants. The atmospheric pollution in urbanised inhabited areas should be taken as a risk factor for cardio-vascular diseases. Monitoring of the quality of atmospheric air provokes multidisciplinary prophylactic interest, including the needs of cardiologic prevention. Scripta Scientifica Medica 2009; 41(2): 135-139

Paroxysmal Atrial Fibrillation: Dynamics of The Main Antioxidant Enzymes - Superoxide Dismutase and Catalase

INTRODUCTION: Researchers have a particularly strong interest in the mechanisms implicated in the clinical manifestation of atrial fibrillation