Myocardial dysfunction associated with proinflammatory cytokines after esophageal resection

Proinflammatory cytokines have been implicated in mediating myocardial dysf unction associated with major surgery. We investigated the profile of proin flammatory cytokines and the association of cytokine levels with myocardial function after esophagectomy. We studied 12 patients who underwent subtota l esophagectomy. One patient died of multiple organ failure. This patient h ad the largest interleukin-6 (IL-6) level of all the subjects. IL-6 levels increased from 14.9 +/- 8.7 pg/mL to 498.4 +/- 294.3 pg/mL (P < 0.05) at 6 h postoperatively. Interleukin-8 (IL-8) levels also significantly increased postoperatively. Right ventricular ejection fraction (RVEF) decreased from 44% +/- 1% to 36% +/- 2% (P < 0.05) and 37% +/- 2% (P < 0.05) at 6 h and 1 2 h postoperatively, Stroke volume index (SVI) decreased significantly at t he end of operation and at 6 h and 12 h postoperatively. The changes of RVE F and SVI showed an independent negative correlation with the nd level (r = - 0.70, P < 0.001 and r = - 0.62, P < 0.001, respectively). In contrast, t he change of RVEF and SVI was not correlated with the IL-8 level. Esophagec tomy is associated with transient depression of myocardial function. IL-6 m ay contribute to this postoperative myocardial dysfunction.