Abstract
Aim. Here, we studied whether the immunoreactivity in pre-operative period defines early postoperative complications in patients with infective endocarditis (IE).Materials and Methods. We consecutively enrolled 110 patients with subacute IE (80 with native-valve IE and 30 with prosthetic valve IE) who underwent a heart valve replacement, then measuring the levels of IgM, IgA, IgG, and complement components in their serum and evaluating their correlation with an adverse early postoperative outcome.Results. Compared with patients< 50 years of age, those ≥ 50 years of age had 2-foldand 3-foldhigher prevalence of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in the early postoperative period. Notably, these numbers correlated with increased С3d and С5а along with reduced Ig М and IgG. IgМ below 9.5 mg/mL and IgG below 2.0mg/mL indicated a 3-foldhigher risk of multiple organ dysfunction syndrome (OR = 3.07, 95% CI = 1.96-4.04, р=0,001).Conclusion. Serum IgM, IgG, and complements factors C3d and C5a may be used as prognostic markers of multiple organ dysfunction syndrome in the early postoperative period.
Highlights
Serum IgM, IgG, and complements factors C3d and C5a may be used as prognostic markers of multiple organ dysfunction syndrome in the early postoperative period
Клиническая апробация полученных в результате исследования данных подтвердила эффективность использования этих маркеров при оценке риска развития осложнений в раннем послеоперационном периоде протезирования клапанов сердца у пациентов с подострым инфекционным эндокардитом
Summary
Установить особенность динамики компонентов системного иммунитета при полиорганной недостаточности в раннем послеоперационном периоде протезирования у пациентов с инфекционным эндокардитом. Оценивая состояние иммунного ответа на дооперационном этапе в группах, разделённых по клиническим признакам наличия осложнений в раннем послеоперационном периоде, выявили, что активность воспаления, оцениваемая по концентрации С-реактивного белка (СРБ), у пациентов группы ПОН в этот период статистически значимо (р=0,0001) выше (таблица 3).
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