Plasma levels of IL-6 correlate with hemodynamic abnormalities in acute pancreatitis in rabbits

Abstract

Objective. To examine the relationship between plasma cytokine levels and cardiac and hemodynamic function.

Design. Measurement of cytokines and the systolic (left ventricular dimensions, heart rate, and cardiac output) and diastolic (early and late transmitral peak flow velocity: E and A-waves and their ratio) functions of the left ventricle (assessed by echocardiography) in rabbits.

Setting and interventions. Laboratory and echocardiographic analyses were performed at baseline and at 1, 3, 6, 12, and 24 h after acute necrotizing pancreatitis induction (Group ANP), in rabbits after somatostatin pretreatment (Group S-ANP) and in sham-operated controls (Group C).

Measurements and results. Left ventricular dilatation occurred at 6 h and cardiac output was increased 3 h after induction of acute necrotizing pancreatitis. Somatostatin pretreatment mitigated the left ventricular enlargement and filling abnormalities. Plasma level of IL-6 was increased significantly 3 h after pancreatitis induction, but to a lesser extent in Group S-ANP, while somatostatin prevented TNFα release (IL-6: Group ANP: 0, 0, 518±139, 956±125, 373±48, and 122±37 pg/ml; Group S-ANP: 0, 0, 191±68, 261±49, 23±13, and 0 pg/ml; TNFα: Group ANP: 88±42, 371±40, 2963±291, 276±30, 197±106, and 23±14 U/l; Group S-ANP: 91±34, 41±25, 68±42, 25±9, 0, and 0 U/ml). The increase in plasma level of IL-6 correlated significantly with left ventricular end-diastolic diameter and volume, cardiac output, and diastolic dysfunction.

Conclusions Plasma levels of IL-6, but not TNFα correlate with cardiac output and left ventricular filling characteristics in acute pancreatitis. Somatostatin pretreatment improves the cardiac and hemodynamic changes, probably through the decrease in cytokine release.