Postpericardiotomy syndrome: the role of genetic factors in the pathogenesis of a systemic inflammatory response after open-heart surgery

Aim. To assess the predictive value of polymorphic variants analyzing of interleukin-6 (IL-6) gene in patients with postpericardiotomy syndrome (PPS) during open-heart surgery.Material and methods. The study included 200 patients. All patients were analyzed for acute phase parameters in serum, effusion fluid and region of IL-6 gene promoter sequence.Results. When analyzing the effusion fluid, in 15% of patients with early PPS, in accordance with the Light RW criteria, transudate was detected. Application of the Roth BJ criteria increased this proportion to 32%. An increase in the level of C-reactive protein (CRP), procalcitonin, and adenosine deaminase (ADA) activity indicated a systemic inflammatory response. The viral genome of cardiotropic viruses was detected in the effusion fluid in 10-12% of patients with PPS. Scanning mutations in the IL-6 500 bp region revealed one polymorphism of -174G>C. The frequency ofPPS in patients with different genotypes (-174GC, -174GG and -174CC) did not significantly differ. An association of the -174GG genotype of the IL-6 gene with a high risk of developing systemic inflammation in open-heart surgery and more frequent postoperative infectious complications has been established. In addition, the -174GG genotype was more often detected in patients with late PPS (p=0,017). There was nocorrelation between the occurrence of genotypes, as well as the distribution of IL-6 gene and coronary obstruction index. However, carriage of the G allele was more often detected in patients with injury of left main coronary artery.Conclusion. The presence of the -174GG genotype of the IL-6 gene and cardiotropic viruses contribute to the systemic inflammation during cardiosurgical interventions in extracorporeal circulation, but do not have predictive value for the PPS development.