title: Inflammatory markers are elevated in Eisenmenger syndrome.
abstract: Inflammation may be an important contributing factor to the progression of Eisenmenger syndrome (ES). Markers of systemic inflammation in ES have not been systematically studied. Inflammatory markers including high-sensitivity C-reactive protein (hs-CRP), interleukin-2 (IL-2), IL-6, and interferon-γ (IFN-γ) were measured in 42 consecutive ES patients (mean age, 24.3 ± 10.6 years) compared with their levels in 22 healthy control subjects. The patients were followed up for a mean duration of 16.3 ± 13.7 months. The levels of inflammatory markers were correlated with clinical and hemodynamic variables at baseline and the outcomes of death, hospitalization, and worsening World Health Organization (WHO) functional class at follow-up evaluation. Compared with the control subjects, ES patients showed a significant elevation in hs-CRP (2.99 ± 3.5 vs 1.1 ± 0.9 mg/dl; p = 0.002) and IFN-γ (41.3 ± 43.6 vs 10.4 ± 6.9 pg/ml; p < 0.001) levels. The levels of IL-2 and IL-6 also were elevated but did not differ significantly from those in the control subjects. The patients with hs-CRP levels higher than 3 mg/dl were significantly older (28.9 ± 10.6 vs 21.5 ± 9.8 years) and had a significantly shorter 6-min walk distance (421.5 ± 133.2 vs 493.3 ± 74.8 m). The levels of inflammatory markers did not correlate with baseline parameters or clinical outcomes. To conclude, the levels of hs-CRP and IFN-γ are significantly elevated in ES. Elevated hs-CRP in ES was associated with older age and shorter 6-min walk distance, but the levels of inflammatory markers were not predictive of clinical events.
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110 029, India, ramaaiims@gmail.com.
authors.forename: Sivasubramanian
authors.initials: S
authors.lastname: Ramakrishnan
authors.forename: Bharat Bhooshan
authors.initials: BB
authors.lastname: Kukreti
authors.forename: Lakshmy
authors.initials: L
authors.lastname: Ramakrishnan
authors.forename: Salman
authors.initials: S
authors.lastname: Salahuddin
authors.forename: Amit
authors.initials: A
authors.lastname: Pendharkar
authors.forename: Ganesan
authors.initials: G
authors.lastname: Karthikeyan
authors.forename: Balram
authors.initials: B
authors.lastname: Bhargava
authors.forename: Rajnish
authors.initials: R
authors.lastname: Juneja
authors.forename: Sandeep
authors.initials: S
authors.lastname: Seth
authors.forename: Shyam S
authors.initials: SS
authors.lastname: Kothari
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Bahl
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D004541:Eisenmenger Complex / Q000097:blood* / Q000150:complications; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein