Plasma IL-18 and IL-18BP are altered differently in reverse remodeling following aortic valve replacement.
OBJECTIVE
Patients with aortic stenosis (AS) develop left ventricular remodeling characterized by changes in extracellular matrix (ECM) and cardiomyocyte-hypertrophy. Aortic valve replacement (AVR) reverses this process (reverse remodeling). We examined plasma levels of interleukin-18 (IL-18) and its binding protein (IL-18BP) before and after AVR for AS since these mediators have been shown experimentally to exert effects on myocardial remodeling.


METHODS
Plasma levels of IL-18 and IL-18BP were analyzed in 22 patients with AS undergoing AVR, preoperatively, two days, six and 12 months postoperatively. Echocardiography and functional testing were performed.


RESULTS
IL-18BP was significantly increased by 28% and 15% at two days and six months after AVR, compared to preoperative values. In contrast, IL-18 showed a later peak (increased by 24% at 12 months postoperatively) when IL-18BP was normalized. IL-18 correlated positively with deceleration time (R = 0.44) at this time-point which might indicate an association with diastolic function.


CONCLUSIONS
We report for the first time that plasma IL-18 and IL-18BP are differentially regulated after AVR for AS with an early increase in IL-18BP postoperatively followed by a later peak in IL-18 at 12 months. Given the known effects of these mediators on myocardial remodeling and function, they might play a role in the reverse and remodeling process associated with AVR.
Majak
Peter
P
Department of Cardiothoracic Surgery and Faculty of Medicine, University of Oslo, Oslo, Norway.
Bjørnstad
Johannes
J
Vengen
Oystein A
OA
Neverdal
Nils O
NO
Husebye
Trygve
T
Woldbaek
Per
P
Pepper
John
J
Lie
Mons
M
Christensen
Geir
G
Tønnessen
Theis
T
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000276:immunology / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D001705:Bioprosthesis; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D005080:Exercise Test; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D020382:Interleukin-18 / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; D020382:Interleukin-18; C118370:interleukin-18 binding protein