Systemic inflammatory response syndrome in end stage heart failure patients following continuous-flow left ventricular assist devices implantation: differences in plasma redox status and leukocyte activation

摘要

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 systemic inflammatory response syndrome (SIRS). We recruited 31 CF-LVAD implanted HF patients (16 SIRS and 15 Non-SIRS) and 11 healthy volunteers as the control. Pre and post implant 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 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 were also prominent in HF patients than control. Persistent oxidative stress and reduced antioxidant status were found more belligerent in HF patients with SIRS after the implantation of CF-LVAD when compared to Non-SIRS patients. Similar to oxidative stress, the activation of blood leukocyte were significantly highlighted in SIRS patients after implantation compared to 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.