title: Systemic Inflammatory Response Syndrome in End-Stage Heart Failure Patients Following Continuous-Flow Left Ventricular Assist Device Implantation: Differences in Plasma Redox Status and Leukocyte Activation.
abstract: The role of oxidative stress and leukocyte activation has not been elucidated in developing systemic inflammatory response syndrome (SIRS) in heart failure (HF) patients after continuous-flow left ventricular assist device (CF-LVAD) implantation. The objective of this study was to investigate the change of plasma redox status and leukocyte activation in CF-LVAD implanted HF patients with or without SIRS. We recruited 31 CF-LVAD implanted HF patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers as the control. Pre- and postimplant blood samples were collected from the HF patients. Plasma levels of oxidized low-density lipoprotein (oxLDL), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD) in erythrocyte, myeloperoxidase (MPO), and polymorphonuclear elastase (PMN-elastase) were measured. The HF patients had a preexisting condition of oxidative stress than healthy controls as evident from the higher oxLDL and MDA levels as well as depleted SOD and TAC. Leukocyte activation in terms of higher plasma MPO and PMN-elastase was also prominent in HF patients than controls. Persistent oxidative stress and reduced antioxidant status were found to be more belligerent in HF patients with SIRS after the implantation of CF-LVAD when compared with non-SIRS patients. Similar to oxidative stress, the activation of blood leukocyte was significantly highlighted in SIRS patients after implantation compared with non-SIRS. We identified that the plasma redox status and leukocyte activation became more prominent in CF-LVAD implanted HF patients who developed SIRS. Our findings suggest that plasma biomarkers of oxidative stress and leukocyte activation may be associated with the development of SIRS after CF-LVAD implant surgery.
authors.affiliation: Department of Surgery, Artificial Organ Lab, University of Maryland School of Medicine, Baltimore, MD, USA.|Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Nandan K
authors.initials: NK
authors.lastname: Mondal
authors.affiliation: Department of Clinical Engineering, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Erik N
authors.initials: EN
authors.lastname: Sorensen
authors.affiliation: Department of Surgery, Artificial Organ Lab, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Si M
authors.initials: SM
authors.lastname: Pham
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Koenig
authors.affiliation: Department of Surgery, Artificial Organ Lab, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Bartley P
authors.initials: BP
authors.lastname: Griffith
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Slaughter
authors.affiliation: Department of Surgery, Artificial Organ Lab, University of Maryland School of Medicine, Baltimore, MD, USA.|Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Zhongjun J
authors.initials: ZJ
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D007962:Leukocytes / Q000473:pathology*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology* / Q000473:pathology
chemical_list: D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D008315:Malondialdehyde
keywords: Heart failure; Left ventricular assist device; Leukocyte activation; Oxidative stress; Systemic inflammatory response syndrome