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Cardiovascular Disorders and Recurrent Infections

Patients with heart diseases are apt to be infected repeatedly. The present study was designed to clarify the relationship between heart diseases and repeated infection. A hundred patients were picked out at random from over 4,000 pediatric heart clinic out-patients at Keio University Hospital. Fourteen of them suffered repeatedly from several kinds of infections. Thirteen of these 14 patients had large left-to-right shunts at the level of either the ductus arteriosus or ventricles. The polymorphonuclear leukocyte (PMN) chemotaxis was tested in 75 patients with cardio-vascular disorders. PMN chemotaxis was measured by Boyden’s double chamber membrane filter system (3pm). These patients were divided into two groups depending on each of the following three factors: 1) with or without cyanosis, 2) with or without congestive heart failure (CHF), and 3) with or without shunt. There were no significant differences in PMN chemotaxis either in the cyanosis groups or in the shunt groups. However, leukotactic malfunction was seen more in patients with CHF than in those without CHF (P<0.005) (See TABLE I). When PMN obtained from CHF patients were preincubated at 37OC for 15 minutes with normal control plasma and then tested, the chemotactic responsiveness was restored. But when normal control PMN were incubated with CHF patient’s plasma, the chemotactic responsiveness was reduced (See FIG. Ib). Therefore, the leukotactic malfunction in CHF patients is not due to an intrinsic factor, but to the effect of those patient’s plasma. This plasma effect is not caused by digoxin, because digoxin at various concentrations (0.5-1,000ng/ml) does not suppress PMN chemotaxis in vitro. These data indicate that the PMN of CHF patients are not suppressed by an intrinsic factor of chemotaxis, but by CHF plasma.