title: Thioredoxin, adiponectin and clinical course of acute fulminant myocarditis.
abstract: BACKGROUND
  In an animal model of viral myocarditis, plasma levels of thioredoxin and adiponectin have been reported to be associated with the severity of inflammation and recovery of ventricular dysfunction, respectively. However, there have been few reports about the clinical significance of these cytokine levels in human myocarditis.
  
  
  OBJECTIVE
  To examine the hypothesis that cytokine levels correlate with clinical courses of patients with acute fulminant myocarditis (FM).
  
  
  METHODS
  A total of 33 consecutive patients with biopsy-proven acute myocarditis were evaluated. Twenty patients were ascribed to an FM group and the other 13 patients were grouped as a non-fulminant group (NFM). Plasma cytokine levels at the time of admission and after 2 weeks were evaluated and correlated with the duration of mechanical circulatory support application.
  
  
  RESULTS
  Plasma thioredoxin level at admission was raised in the FM group (3.08±2.15 ng/ml) compared with the NFM group (1.63±0.45 ng/ml, p=0.011) and reduced after an initial unstable period. However there was no significant difference in plasma adiponectin level between the two groups. In a multivariable regression model, increased plasma thioredoxin level (OR=5.79, 95% CI 1.67 to 20.1, p=0.006) and reduced plasma adiponectin level (OR=0.16, 95% CI 0.055 to 0.49, p=0.001) were associated with longer duration of mechanical circulatory support application in the patients with FM, which in turn was significantly related to death or cardiac transplantation.
  
  
  CONCLUSIONS
  In patients with acute myocarditis, the plasma thioredoxin level was increased in the more severe form, and a reduced level of adiponectin was closely correlated with worse short-term outcome in patients with FM.
authors.affiliation: Division of Cardiology, Department of Medicine, Seoul, Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Choi
authors.forename: Soo-Hyeon
authors.initials: SH
authors.lastname: Yun
authors.forename: Kiick
authors.initials: K
authors.lastname: Sung
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Joong-Il
authors.initials: JI
authors.lastname: Park
authors.forename: Eun-Seon
authors.initials: ES
authors.lastname: Ju
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Duk-Kyung
authors.initials: DK
authors.lastname: Kim
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Jeon
mesh_terms: D000208:Acute Disease; D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D011379:Prognosis; D013879:Thioredoxins / Q000097:blood*; D014777:Virus Diseases / Q000097:blood / Q000175:diagnosis; D055815:Young Adult
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D016207:Cytokines; D013879:Thioredoxins