title: TNF-α, myocardial perfusion and function in patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention.
abstract: OBJECTIVE
  To characterize the time course of tumor necrosis factor-α (TNF-α) serum levels along with myocardial perfusion and contractile function in patients with ST-segment elevation myocardial infarction (STEMI) and successful primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Serum levels of TNF-α, interleukin 6 (IL-6), and C-reactive protein (CRP) were measured in 42 patients with STEMI before, one and 6 days after successful PCI. Myocardial perfusion was assessed by contrast-enhanced echocardiography (ceEcho), contractile function by unenhanced two-dimensional (2DE) and real-time three-dimensional echocardiography. In a subset of 18 patients, infarct size was quantified by late gadolinium enhancement cardiovascular magnetic resonance imaging (LGE-CMR) on day six.
  
  
  RESULTS
  TNF-α serum levels were in the upper normal range within the first 12 h from symptom onset and increased continuously until day six, while IL-6 and CRP increased subsequently with a peak on day one after STEMI. Serum TNF-α on day one after PCI correlated with perfusion defects, wall motion abnormalities, and infarct size (ceEcho: r = 0.52, p = 0.005; 2DE: r = 0.56, p = 0.002; LGE-CMR: r = 0.83-0.86; p < 0.0001). Using multiple regression linear analysis, infarct size on day six was predicted by serum TNF-α 1 day after PCI (p = 0.006, adjusted R                            (2) 0.638).
  
  
  CONCLUSIONS
  Our data reflect the clinical significance of early TNF-α elevation in patients with STEMI and primary PCI (Controlled Clinical Trials number, NCT00529607).
authors.affiliation: Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Department of Medicine, University Hospital Aachen, 52074 Aachen, Germany.
authors.forename: Eva S
authors.initials: ES
authors.lastname: Kehmeier
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lepper
authors.forename: Martina
authors.initials: M
authors.lastname: Kropp
authors.forename: Christian
authors.initials: C
authors.lastname: Heiss
authors.forename: Ulrike
authors.initials: U
authors.lastname: Hendgen-Cotta
authors.forename: Jan
authors.initials: J
authors.lastname: Balzer
authors.forename: Mirja
authors.initials: M
authors.lastname: Neizel
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Marc W
authors.initials: MW
authors.lastname: Merx
authors.forename: Pablo E
authors.initials: PE
authors.lastname: Verde
authors.forename: Christian
authors.initials: C
authors.lastname: Ohmann
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D004452:Echocardiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D005260:Female; D005682:Gadolinium; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D005682:Gadolinium