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TNFβ +250 polymorphism and hyperdynamic state in cardiac surgery with extracorporeal circulation
Critical Care volume 13, Article number: P351 (2009)
We have investigated genetic and clinical factors associated with the hyperdynamic state (HS) after heart surgery with extracorporeal circulation (ECC).
We performed a prospective cohort study of consecutive patients who underwent elective heart surgery with ECC. The HS was defined as hyperthermia (>38°C), cardiac index (CI) >3.5 l/min/m2 and systemic vascular resistance index (SVRI) <1,600 dynes × s/cm5 × m2. The study included demographic variables, gene polymorphisms (A/G) of TNFβ +250, G/A-1082 of IL-10, polymorphism of IL-1 receptor antagonist, comorbidity, type of surgery, serum levels of IL-6, and postoperative course. We used the Pearson chi-square test or Fischer exact test, and the Student t test for univariate analysis, with forward stepwise logistic regression for multivariate adjustment.
Eighty patients were studied, of whom 22 (27.5%) developed HS. The presence of allele G of TNFβ +250 polymorphism was associated with an increased incidence of HS (68% vs. 37%; P = 0.011). In the multivariate analysis, a longer duration of ECC, and the presence of the G allele, were associated with the development of HS.
The G allele of TNFβ +250 polymorphism, and prolonged extracorporeal circuit times, may favour the development of a hyperdynamic state after heart surgery with ECC.
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Iribarren, J., Jimenez, J., Brouard, M. et al. TNFβ +250 polymorphism and hyperdynamic state in cardiac surgery with extracorporeal circulation. Crit Care 13, P351 (2009). https://doi.org/10.1186/cc7515
- Receptor Antagonist
- Gene Polymorphism
- Prospective Cohort
- Cardiac Index
- Prospective Cohort Study