Increased interleukin-1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention

Abstract. Ørn S, Ueland T, Manhenke C, Sandanger Ø, Godang K, Yndestad A, Mollnes TE, Dickstein K, Aukrust P (Stavanger University Hospital, Stavanger; Oslo University Hospital Rikshospitalet; University of Bergen, Bergen; University of Oslo; Oslo; Norway). Increased interleukin‐1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention. J Intern Med 2012; 272: 267–276. Objectives. To assess the relationship between interleukin (IL)‐1‐related molecules, infarct size and left ventricular (LV) remodelling following acute myocardial infarction (MI). Methods. Forty‐two patients with first‐time diagnosis of ST segment elevation MI (STEMI), with a single occluded vessel successfully revascularized by primary percutaneous coronary intervention (PCI), were recruited to this observational study conducted at a university teaching hospital and followed for 1 year. Main outcome measures. Plasma levels of IL‐1β, IL‐1 receptor antagonist (IL‐1Ra), IL‐18 and caspase‐1 were analysed before and 2 days, 1 week and 2 months after PCI. Serial cardiac magnetic resonance imaging (CMR) was used for the assessment of infarct size and LV remodelling. CMR findings at 1 year was the primary outcome variable. Results. Univariate analysis showed that IL‐1‐related mediators were strongly (IL‐1 β), moderately (caspase‐1) and weakly (IL‐1Ra) associated with impaired myocardial function and noninfarct mass, but not infarct size, 1 year after reperfused STEMI. In multivariate analyses, troponin T predicted LV ejection fraction (LVEF), infarct size and LV end‐diastolic (LVEDVi) and end‐systolic volume index (LVESVi). However, significant additional variance was explained by IL‐1β, IL‐18 and caspase‐1. IL‐1β levels at 2 months, IL‐18 at 2 days and pre‐PCI caspase‐1 were predictors of LVEF. Caspase‐1 and in particular IL‐1β at 2 days were the only predictors of noninfarct mass. IL‐1β and IL‐18 at 2 days were predictors of LVEDVi, whilst pre‐PCI levels of IL‐1β contributed to prediction of LVESVi. By contrast, pro‐B‐type natriuretic peptide, C‐reactive protein, IL‐6 and transforming growth factor‐β1 (TGF‐β1) had no or only a weak (TGF‐β1) association with these CMR parameters in multivariate analyses. Conclusions. IL‐1β levels after STEMI were strongly associated with impaired myocardial function and noninfarct LV mass after 1 year, suggesting a potential role for IL‐1β as a predictor of maladaptive myocardial remodelling following reperfused MI.     

A long-term follow-up study of juvenile aneurysm patients

Summary The long-term outcome in 26 patients following operation of intracranial saccular aneurysms before the age of twenty is presented. The duration of follow-up ranged from 4 to 33 years (mean 14 years). The oldest patient is now 51 years old. 19 patients (73%) made a complete or good recovery with resumption of normal life. Only one patient was severely disabled and dependent for daily support. Aspects of social outcome such as working conditions and family relationships were encouraging. No association between presence of vasospasm in the acute phase of the disease and the long-term outcome was demonstrated. In one case rupture of a previously undetected aneurysm had occurred during the followed-up period.     

Analysis of immediate changes of water-soluble metabolites in alkali-burned rabbit cornea, aqueous humor and lens by high-resolution 1H-NMR spectroscopy

PURPOSE: To investigate immediate changes in water-soluble metabolites of ocular tissue in alkali-burned eyes by using high-resolution 1H-NMR spectroscopy. METHODS: Adult New Zealand rabbit eyes were burned with 1 M NaOH for 1 min. Normal eyes were used as control. Samples from aqueous humor and perchloric acid extracts of the cornea and lens were analyzed on a NMR spectrometer operating at 500 MHz for protons. Metabolites were quantified by comparing peak area with an added internal standard, TSP (3'-trimethylsilylpropinate-2,2,3,3-d4). RESULTS: Alkali burn of corneal surface causes immediate changes in concentration of many water-soluble metabolites in the anterior segment. Even as far away as the lens a significant increase in lactate was found. Cornea showed a significant increase in glucose and a significant decrease in hypo-taurine concentration. Most changes were observed in aqueous humor, with significant increases in succinate, creatine, scyllo- and myo-inositol and a significant decrease in citrate concentration. Furthermore, a small decrease in ascorbate concentration in aqueous humor was observed. CONCLUSIONS: The present study provides a valuable contribution to the knowledge of metabolic alterations in alkali-burned eyes. It shows that 1H-NMR spectroscopy is well suited for simultaneous qualitative and quantitative analysis of changes of metabolite concentrations in damaged tissues. This can help us to better evaluate and understand the biological alterations due to alkali burn.     

Feto-maternal bleeding following coelocentesis

The potential risk of feto-maternal haemorrhage following coelocentesis was examined in 17 singleton pregnancies at 6-11 weeks of gestation by measuring maternal serum concentration of alpha fetoprotein (AFP) before and 1 and 10 min after the procedure. There was no significant difference between the maternal serum AFP concentration before coelocentesis (median 7.5, range 4.5-21.5 IU) compared to the values at 1 min (median 8.6, range 3.9-17.8; Z = -0.504, P = 0.614), and 10 min (median 7.5, range 5.7-20.6; Z = -0.432, P = 0.666) after the procedure. These findings demonstrate that coelocentesis is not associated with significant feto-maternal haemorrhage.      

Intravenous urography and voiding cystoureterography in northern Norway: a retrospective study

Intravenous urography (IU) was performed in 489 patients aged 0–9 years during 1980–1983. A total of 35 (7.2%), 19 (13.1%) boys and 16 (4.7%) girls had pathological changes at IU. Of these, 11 boys and 5 girls had findings with therapeutic consequences. We have analysed the results of IU and voiding cystoureterography (VC) in 62 patients and show that a normal IU does not exclude vesicoureteral reflux into the renal pelvis. By performing only VC hydronephrosis, pyelonephritic scarring and anomalies may be missed.