Association of anti-heart antibodies and circulating immune complexes in the post-pericardiotomy syndrome.
The post-pericardiotomy syndrome (PPS) is a common complication of cardiac surgery. In order to better understand the pathogenesis of this complication we undertook a prospective, triple blind study of consecutive long term survivors of cardiac surgery. We followed 82 patients and determined anti-heart antibodies (AHA), circulating immune complexes (CIC) and anti-viral antibodies (AVA) on sera pre-operatively and serially post-operatively. According to the clinical features of pericarditis, fever and leucocytosis, patients were divided into three groups: (1) complete PPS with all three symptoms, (2) incomplete PPS with two symptoms and (3) no PPS with one or no symptoms. Clinical PPS was found in 16 patients (19.6%). All of these patients had positive AHA, 12 patients (75%) had increased CIC and five patients (31%) had a four-fold or greater rise in titre to viruses studied. Twenty-four patients (29.2%) had an incomplete PPS. It was accompanied by positive AHA in 17 patients (70.8%), increased CIC in 14 patients (58.3%) and a four-fold rise or greater in virus titre in seven patients (29.2%). No PPS was found in forty-two patients (51.2%). It was accompanied by positive AHA in eight patients (19%), increased CIC in 10 patients (24%) and a four-fold or greater rise in virus titre in 12 patients (28.6%). There was a good correlation between the presence of PPS, AHA, CIC and the type of operation. Heart valve replacement surgery was more frequently complicated by PPS. Development of post-operative AHA and increased CIC were also more frequently found. We found a good correlation between PPS, positive AHA and increased CIC. No correlation was found between PPS and virus serology.
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis*; D000936:Antigen-Antibody Complex / Q000032:analysis*; D001323:Autoantibodies / Q000032:analysis*; D005260:Female; D006331:Heart Diseases / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology*; D011185:Postpericardiotomy Syndrome / Q000276:immunology*; D011446:Prospective Studies
D000914:Antibodies, Viral; D000936:Antigen-Antibody Complex; D001323:Autoantibodies