JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (30) Citing Articles via Google Scholar Google Scholar Articles by Tomasdottir, H. Articles by Ricksten, S.-E. Search for Related Content PubMed PubMed Citation Articles by Tomasdottir, H. Articles by Ricksten, S.-E. Related Collections Economics and Health Care Research Postanesthetic Care Unit Complications Monitoring (Cardiac)

---

CARDIOVASCULAR ANESTHESIA

Tumor Necrosis Factor Gene Polymorphism Is Associated with Enhanced Systemic Inflammatory Response and Increased Cardiopulmonary Morbidity After Cardiac Surgery

Departments of Anesthesia and Intensive Care and Clinical Chemistry, Section of Molecular Biology, Sahlgrenska University Hospital, Göteborg, Sweden

Address correspondence and reprint requests to Sven-Erik Ricksten, MD, PhD, Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. Address e-mail to sven-erik.ricksten{at}aniv.gu.se

Cardiopulmonary bypass induces a systemic inflammatory response characterized by alterations in cardiopulmonary function. Mediators for this morbidity are the cytokines tumor necrosis factor (TNF)- and interleukins. A genomic polymorphism within the TNF locus is associated with increased TNF- levels and high mortality in severe trauma and sepsis. We assessed the relationship of biallelic polymorphisms of the TNF locus in patients undergoing elective cardiac surgery to release of proinflammatory cytokines and cardiopulmonary morbidity. TNF genotypes, plasma concentrations of TNF-, interleukin-6, and cardiopulmonary morbidity were studied in 95 unselected, consecutive patients undergoing routine cardiac surgery. TNF genotypes were determined by the solid-phase minisequencing method. Patients homozygous for the TNFB2 allele (n = 42) displayed larger peak concentrations of TNF- (11.3 ± 1.3 versus 7.8 ± 0.7 pg/mL; P = 0.013) and interleukin-6 (153 ± 27 versus 87 ± 7 pg/mL; P = 0.010) when compared with patients homozygous or heterozygous for TNFB1 (n = 53). The TNFB2 homozygotes had a higher incidence of left ventricular dysfunction (31% versus 9%; P = 0.029; odds ratio 3.84 [95% confidence interval, 1.40–24.3]), postoperative pulmonary dysfunction (24% versus 6%; P = 0.016; odds ratio 5.21 [95% confidence interval, 1.49–18.3]), and a lower pulmonary oxygenation index (29 ± 1.9 versus 36.1 ± 1.8; P = 0.013). Patients homozygous for the TNFB2 allele may develop an enhanced systemic inflammatory response with an increased risk of cardiopulmonary morbidity after cardiac surgery.

IMPLICATIONS: The associations between tumor necrosis factor (TNF) gene polymorphism, plasma cytokines, and cardiopulmonary function after elective cardiac surgery were evaluated. Patients homozygous for the TNFB2 allele displayed larger concentrations of TNF- and interleukin-6 and had an increased risk of developing left ventricular and pulmonary dysfunction compared with TNFB1 homo- or heterozygotes.

This article has been cited by other articles:

				D. Paparella, G. Scrascia, A. Galeone, M. Coviello, G. Cappabianca, M. T. Venneri, B. Favoino, M. Quaranta, L. de Luca Tupputi Schinosa, and T. E. Warkentin Formation of anti-platelet factor 4/heparin antibodies after cardiac surgery: influence of perioperative platelet activation, the inflammatory response, and histocompatibility leukocyte antigen status. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1456 - 1463. [Abstract] [Full Text] [PDF]

				J. L. Iribarren, F. M. Sagasti, J. J. Jimenez, M. Brouard, E. Salido, R. Martinez, and M. L. Mora TNF{beta}+250 polymorphism and hyperdynamic state in cardiac surgery with extracorporeal circulation Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1071 - 1074. [Abstract] [Full Text] [PDF]

				J. Cha, Z. Wang, L. Ao, N. Zou, C. A. Dinarello, A. Banerjee, D. A. Fullerton, and X. Meng Cytokines Link Toll-Like Receptor 4 Signaling to Cardiac Dysfunction After Global Myocardial Ischemia Ann. Thorac. Surg., May 1, 2008; 85(5): 1678 - 1685. [Abstract] [Full Text] [PDF]

				H. P. Grocott Genetic influences on cerebral outcome after cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 291 - 296. [Abstract] [PDF]

				R. Ryan, J. Thornton, E. Duggan, E. McGovern, M. J. O'Dwyer, A. W. Ryan, D. Kelleher, R. McManus, and T. Ryan Gene polymorphism and requirement for vasopressor infusion after cardiac surgery. Ann. Thorac. Surg., September 1, 2006; 82(3): 895 - 901. [Abstract] [Full Text] [PDF]

				Z. Xia, Z. Huang, and D. M. Ansley Large-Dose Propofol During Cardiopulmonary Bypass Decreases Biochemical Markers of Myocardial Injury in Coronary Surgery Patients: A Comparison with Isoflurane. Anesth. Analg., September 1, 2006; 103(3): 527 - 532. [Abstract] [Full Text] [PDF]

				H. Riha, J. A. Hubacek, R. Poledne, P. Kellovsky, A. Brezina, and J. Pirk IL-10 and TNF-beta gene polymorphisms have no major influence on lactate levels after cardiac surgery. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 54 - 58. [Abstract] [Full Text] [PDF]

				R. S. Jawa, M. N. Kulaylat, H. Baumann, and M. T. Dayton What Is New in Cytokine Research Related to Trauma/Critical Care J Intensive Care Med, March 1, 2006; 21(2): 63 - 85. [Abstract] [PDF]

				J. M. McCaffery, N. Frasure-Smith, M.-P. Dube, P. Theroux, G. A. Rouleau, Q. Duan, and F. Lesperance Common genetic vulnerability to depressive symptoms and coronary artery disease: a review and development of candidate genes related to inflammation and serotonin. Psychosom Med, March 1, 2006; 68(2): 187 - 200. [Abstract] [Full Text] [PDF]

				J. W. Newburger and D. C. Bellinger Brain Injury in Congenital Heart Disease Circulation, January 17, 2006; 113(2): 183 - 185. [Full Text] [PDF]

				M. N. Bittar, J. A. Carey, J. B. Barnard, V. Pravica, A. K. Deiraniya, N. Yonan, and I. V. Hutchinson Tumor Necrosis Factor Alpha Influences the Inflammatory Response After Coronary Surgery Ann. Thorac. Surg., January 1, 2006; 81(1): 132 - 137. [Abstract] [Full Text] [PDF]

				T. G. Monk, V. Saini, B. C. Weldon, and J. C. Sigl Anesthetic Management and One-Year Mortality After Noncardiac Surgery Anesth. Analg., January 1, 2005; 100(1): 4 - 10. [Abstract] [Full Text] [PDF]

				A. A. Fox, S. K. Shernan, and S. C. Body Predictive Genomics of Adverse Events After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2004; 8(4): 297 - 315. [Abstract] [PDF]

				C. Weissman Pulmonary Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 185 - 211. [Abstract] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999