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Elevated resting and agonist-induced whole blood chemiluminescence in patients with active infective endocarditis

^a Departament of Cardiosurgery, Medical University of Lodz, Poland
^b Bases of Clinical Medicine Teaching Center, Medical University of Lodz, Kopcinskiego St. 20, 90-153 Lodz, Poland
^c Department of Chest Surgery, Oncologic and General Surgery, University Hospital No. 2, Medical University of Lodz, Poland
^d Department of Clinical Physiology, Medical University of Lodz, Mazowiecka St. 6/8, 92-215 Lodz, Poland

*Corresponding author. Tel.: +48-42-6782661; fax: +48-43-6782661.

E-mail address: dnowak{at}zdn.am.lodz.pl (D. Nowak).

Infective endocarditis (IE) and surgical procedures related to cardiac surgery are accompanied by inflammatory responses that may alter production of oxidants by phagocytes. This study evaluates luminol enhanced whole blood chemiluminescence (LBCL) as a measure of oxidative production by circulating phagocytes in 26 IE patients in comparison to 27 matched patients with acquired valvular heart disease and 25 healthy controls. Blood was collected the day before and 3, 7, 12 and 21 days after valve replacement surgery for LBCL measurement; resting (rCL) and agonist (fMLP)-stimulated total light emission (tCL). Preoperative rCL and tCL with values observed after 3, 7, 14, and 21 days from surgery were higher (P<0.01) in patients with IE than in healthy controls. Median preoperative rCL, and tCL was about 2.5-times higher (P<0.01) in IE group than in patients with valvular heart disease (4.3 vs. 1.7 U/10⁴ phagocytes and 2473 vs. 782 Uxs/10⁴ phagocytes). Three days after valve replacement, LBCL rose three times (P<0.01) in both operated groups. With patient recovery, LBCL decreased and no differences were noted between groups. Patients with IE had elevated LBCL reflecting increased oxidants release from circulating phagocytes that may predispose to the development of oxidative stress.

Key Words: Infective endocarditis; Whole blood chemiluminescence; Valvular heart disease; Valve replacement; Oxidative stress; Circulating phagocytes