Inflammatory Markers Are Elevated in Eisenmenger Syndrome

  • Dr S Ramakrishnan, All India Institute of Medical Sciences, New Delhi, India
  • Dr Amit Pandharkar, All India Institute of Medical Sciences, New Delhi, India
  • Prof Shyam Kothari, All India Institute of Medical Sciences, New Delhi, India
  • Prof Anita Saxena, All India Institute of Medical Sciences, New Delhi, India
  • Prof Balram Bhargava, All India Institute of Medical Sciences, New Delhi, India
  • Dr Rajnish Juneja, All India Institute of Medical Sciences, New Delhi, India
  • Dr Ganesan Karthikeyan, All India Institute of Medical Sciences, New Delhi, India
  • Dr R Lakshmy, All India Institute of Medical Sciences, New Delhi, India

    • Purpose
    Inflammation is considered to be one of the important factors in the progression Eisenmenger syndrome (ES). Markers of systemic inflammation are not yet studied in Eisenmenger syndrome.
    Methods
    Twenty-two consecutive symptomatic patients of ES with a mean age of 24 ± 10.6 years, were enrolled in the study. Six (27%) patients had atrial septal defect, 8 patients (36%) had ventricular septal defect and 8 patients (36%) had patent ductus arteriosus. Thirteen (59%) patients were in WHO functional class II and nine (41%) patients were in WHO class III. Inflammatory markers including hs-CRP (high sensitivity C-reactive protein), interleukin-2, interleukin-6 and interferon γ were assayed with commercially available kits using ELISA and the values were compared with 6 healthy controls.
    Results
    There is significant elevation in hs-CRP and interferon γ levels as compared to controls. The results are summarized in Table 1.
    Conclusion: Inflammatory markers including hs-CRP and interferon γ are significantly elevated in Eisenmenger syndrome. The causes, consequences and prognostic significance of such elevations need further evaluation.

    Biomarker Eisenmenger Syndrome n = 22 Control n = 6 P Value
    hs CRP (mg/L) 3.5 + 2.8 0.6 + 0.4 0.04
    Interferon - γ (pg/ml) 21.7 + 12.70 8.7 + 3.94 0.02
    Interleukin – 6 (pg/ml) 12.07 + 19.59 2 + 1.22 0.22
    Interleukin – 2 (pg/ml) 19.41 + 13.56 15 + 12.24 0.52