Variations in lymphocyte activation during exercise testing in patients with coronary artery disease.
BACKGROUND
Several studies have shown that strenuous exercise induces changes in the immune system. Soluble interleukin-2 receptor (sIL-2R) is a marker of immune system activation and is known to increase in association with cardiac disease. The aim of the present study was to assess sIL-2R levels in patients with coronary artery disease (CAD) in conjunction with exercise testing.


METHODS
Blood levels of sIL-2R were determined in 10 healthy control individuals and 21 patients with CAD before exercising, at maximal exercise testing (Bruce) and at 0.5 h and 3-4 h after exercise (T1-T4). The study group had stable angina and normal or near-normal left ventricular function. Patients at risk of abnormal cytokine levels were excluded.


RESULTS
The patients were divided into two groups: those with mild to moderate ischemia (according to a thallium scan) (n = 14, group 1a) and those with severe exercise-induced ischemia (n = 7, group 1b). The prevalence of anginal pain at exercise and mean ST depression were similar in both groups, however, signs of left ventricular dysfunction during exercise were significantly more frequent in group 1b. Mean sIL-2R levels (units per ml) showed no significant difference between group 1a and the control group at all time points (503 +/- 122, 518 +/- 140, 489 +/- 164, 461 +/- 131 mu/ml compared with 505 +/- 135, 509 +/- 112, 469 +/- 126, 416 +/- 103 mu/ml, respectively, P = NS), while a significant increase in group 1b compared with the control group was found at 0.5-h after exercise (T3) (1147 +/- 510 mu/ml, P = 0.03).


CONCLUSIONS
This study demonstrated immunological involvement in some patients with severe exercise-induced ischemia shortly after exercise, suggesting an association with heart failure.
Zafrir
Nili
N
Department of Cardiology, Tel Aviv University, Israel. zafrimd@isdn.net.il
Shohat
Batya
B
Ben-Gal
Tuvia
T
Solodky
Alejandro
A
Sulkes
Jaqueline
J
Battler
Alexander
A
D000368:Aged; D000704:Analysis of Variance; D000787:Angina Pectoris / Q000453:epidemiology / Q000276:immunology; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000276:immunology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015375:Receptors, Interleukin-2 / Q000097:blood*; D018709:Statistics, Nonparametric; D013601:T-Lymphocytes / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000276:immunology
D015375:Receptors, Interleukin-2