Biomedical subjects

Steve F Bolling

Publications and source records attributed to Steve F Bolling.

2 recordsLinked to original sources

PubMed2005

Effects of mood state and psychosocial functioning on plasma Interleukin-6 in adult patients before cardiac surgery.

OBJECTIVE: The purpose of this study was to examine the potential effect of mood states and psychosocial functioning during the waiting weeks prior to major cardiac surgery on the plasma Interleukin-6 (IL-6) levels in 236 patients immediately before their operation. METHOD: The sample was recruited from patients at the cardiac clinic of the University of Michigan Medical Center (Ann Arbor). Two weeks before cardiac surgery, trained research assistants conducted a face-to-face interview with these middle-aged and older patients on their preoperative physical examination date at the clinic. Standardized instruments were used to assess mood states and psychosocial functioning. The blood samples of 236 patients, obtained on the morning of the operation, were analyzed for plasma IL-6. RESULTS: In bivariate analysis, poor psychological functioning and anxiety, as well as bodily pain and body mass index (BMI), were correlated with plasma IL-6 (p < .05), but sociodemographics, chronic illness and use of psychotropic medications were not. When the effect of bodily pain and BMI were taken into account, partial correlation analysis showed that psychological functioning continued to be associated with plasma IL-6 (p < .05); the association of IL-6 with depression now became significant (p < .05), whereas that with anxiety became even more significant (p < .001). CONCLUSIONS: Preoperative psychological disturbances during the waiting weeks before cardiac surgery may influence the plasma levels of IL-6 immediately prior to the procedure. The clinical implications of these findings remain to be determined.

Adult↗

PubMedDate not supplied

Mitral valve surgery: when is it appropriate?

Mitral regurgitation (MR) is a frequent complication of end-stage cardiomyopathy. Historically, these patients were managed either medically or with mitral valve replacement, both associated with poor outcomes. We studied 150 patients with cardiomyopathy and severe MR who were managed with mitral reconstruction. One hundred fifty patients with 4+ MR, left ventricular ejection fractions of 8%-24% (mean, 14%), and New York Heart Association class III or IV symptoms were prospectively studied. All patients underwent mitral valve repair with an undersized, flexible annuloplasty ring. There was one intraoperative death and seven 30-day mortalities. Intraoperative echocardiography revealed no residual MR in the majority of patients and mild to trivial MR in seven patients. There were 27 late deaths; three of these patients had progression of the disease and underwent transplantation. The 1-, 2-, and 5-year actuarial survival rates are 82%, 71%, and 57%, respectively. New York Heart Association class has improved for all patients, from a preoperative mean of 3.2+/-0.2 to 1.8+/-0.4 postoperatively. At 24-month follow-up, all patients showed improvement in ejection fraction, cardiac output, and end-diastolic volumes, along with a reduction in the sphericity index and regurgitant volume. Mitral valve repair with an undersized, flexible annuloplasty ring is a safe and effective approach to correction of MR, even in cardiomyopathy patients. All observed changes contribute to reverse remodeling and the restoration of the normal left ventricular geometric relationship. Mitral reconstruction provides a new first-line management strategy for patients with MR and end-stage heart failure.

Cardiomyopathy, Dilated↗