Interleukin-6 and tumor necrosis factor alpha in relation to myocardial infarct size and collagen formation.
BACKGROUND
Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) 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-alpha, 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-alpha levels, and patients with left ventricular dysfunction (EF<40%) had similar TNF-alpha 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-alpha measurement is useless in the assessment of infarct size or left ventricular function during the immediate post-infarction period.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D019540:Area Under Curve; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D003094:Collagen / Q000097:blood* / Q000187:drug effects; D003402:Creatine Kinase / Q000187:drug effects / Q000378:metabolism; D052279:Creatine Kinase, MB Form; D004562:Electrocardiography; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005387:Finland; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007527:Isoenzymes / Q000187:drug effects / Q000378:metabolism; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D010446:Peptide Fragments / Q000097:blood / Q000187:drug effects; D011347:Procollagen / Q000097:blood / Q000187:drug effects; D000077583:Quinapril; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013318:Stroke Volume / Q000187:drug effects; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014303:Trinitrotoluene / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000187:drug effects / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology
D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D015850:Interleukin-6; D007527:Isoenzymes; D010446:Peptide Fragments; D011347:Procollagen; D044005:Tetrahydroisoquinolines; D014409:Tumor Necrosis Factor-alpha; C041876:procollagen Type III-N-terminal peptide; D014303:Trinitrotoluene; D004656:Enalapril; D003094:Collagen; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D000077583:Quinapril