Inflammatory Factor Variation Pre And Post Intervention In Adults With Congenital Heart Diseases

Objective To investigate the Inflammatory factor changes in patients with congenital heat disease and the effect of transcatheter closure on immune activities by comparing the levels of Inflammatory factors before and after the procedure.Methods 55 patients with congenital heart disease(CHD group) including 40 ones have undergone transcatheter closure and 30 healthy normal control subjects(NC group)were involved in the study.(1)Serum concentrations of tumor necrosis factor(TNF)-α,interleukin-6(IL-6)and interleukin-10(IL-10)were assayed in patients and controls by enzyme linked immunosorbent assay(ELISA).Blood samples for analysis were collected from the patients before the closure and 3 month,6 month after the closure respectively.(2)The activity of NF-κB of 30 atrial septum defects in adults and 30 control subjects was measured by immunocytochemical staining.Results(1)Adults with congenital heart disease had higher levels of TNF-α,IL-6 and IL-10(P＜0.01),compared with nomal controls.TNF-α/IL 10 increased more significantly(P＜0.01).The levels of TNF and IL-6 in all CHD subgroups(graded by heart function)showed highly significant stepwise increases(P＜0.05).The level of IL-10 was lower in patients with worse heart function(P＜0.05),but still higher than nomal controls(P＜0.01).The levels of TNF-α,IL-6 and IL-10 obviously declined from 3 month after the closure(P＜0.01),and returned to normal level in 6 month after the procedure(P＞0.05 versus control).(2)Compared with the healthy subject,NF-κB activation,TNF-α, IL-6 and IL-10 levels of adult patients with atrial septim defect increased significantlly(P＜0.01).NF-κB activation was positively correlated with the levels of TNF-αand IL-6(P＜0.01).Conclusions(1)Immune activation exists to some extent in adults with congenital heart disease,relating to the severity of heart failure,and gradually returns to normal status in 6 month after transcatheter closure.(2)NF-κB possibly up-regulates the levels of TNF-αand IL-6 of adult patients with atrial septim defect.