Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure
Mathias Rauchhaus,Wolfram Doehner,Darrel P. Francis,Constantinos H. Davos,Michael Kemp,Christa Liebenthal,Josef Niebauer,James Hooper,Hans-Dieter Volk,Andrew J.S. Coats,Stefan D. Anker +10 more
TLDR
Assessment of sT NF-R1 may be useful in identifying patients who are at high risk of death and in monitoring patients undergoing anti-TNF-alpha treatment, independent of established markers of CHF severity.Abstract:
BACKGROUND: Inflammatory immune activation is an important feature in chronic heart failure (CHF). Little is known about the prognostic importance of tumor necrosis factor-alpha (TNF-alpha), soluble TNF-receptor 1 and 2 (sTNF-R1/sTNF-R2), interleukin-6 (IL-6), and soluble CD14 receptors (sCD14) in CHF patients. METHODS AND RESULTS: In 152 CHF patients (age 61+/-1 years, New York Heart Association [NYHA] class 2.6+/-0.1, peak VO(2) 17.3+/-0.6 mL. kg(-1). min(-1), mean+/-SEM) plasma concentrations of immune variables were prospectively assessed. During a mean follow-up of 34 months (>12 months in all patients), 62 patients (41%) died. Cumulative mortality was 28% at 24 months. In univariate analyses, increased total and trimeric TNF-alpha, sTNF-R1, and sTNF-R2 (all P</=0.0001), sCD14 (P=0.0007), and IL-6 (P=0.005) predicted 24-month mortality. With multivariate analysis and receiver operating characteristics, sTNF-R1 emerged among all cytokine parameters as the strongest and most accurate prognosticator in this CHF population, regardless of follow-up duration and independently of NYHA class, peak VO(2), VE/VCO(2) slope, left ventricular ejection fraction, and wasting (P<0.001). The receiver operating characteristic area under the curve for sTNF-R1 was greater than for sTNF-R2 at 6, 12, and 18 months (all P<0.05). CONCLUSIONS: sTNF-R1 was the strongest and most accurate prognosticator, independent of established markers of CHF severity. Assessment of sTNF-R1 may be useful in identifying patients who are at high risk of death and in monitoring patients undergoing anti-TNF-alpha treatment.read more
Citations
More filters
Journal ArticleDOI
2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries
Victor Aboyans,Jean-Baptiste Ricco,Marie-Louise Bartelink,Martin Björck,Marianne Brodmann,Tina Cohnert,Jean-Philippe Collet,Martin Czerny,Marco De Carlo,Sebastian Debus,Christine Espinola-Klein,Thomas Kahan,Serge Kownator,Lucia Mazzolai,A. Ross Naylor,Marco Roffi,Joachim Röther,Muriel Sprynger,Michal Tendera,Gunnar Tepe,Maarit Venermo,Charalambos Vlachopoulos,Ileana Desormais +22 more
TL;DR: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) as mentioned in this paper, covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries
Journal ArticleDOI
Cytokines and Cytokine Receptors in Advanced Heart Failure An Analysis of the Cytokine Database from the Vesnarinone Trial (VEST)
Anita Deswal,Nancy J. Petersen,Arthur M. Feldman,James B. Young,Bill G. White,Douglas L. Mann +5 more
TL;DR: In this paper, the authors analyzed circulating levels of cytokines (tumor necrosis factor [TNF] and interleukin-6) and their cognate receptors in 1200 consecutive patients who were enrolled in a multicenter clinical trial of patients with advanced heart failure.
Journal ArticleDOI
Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial
Stefanie S. Schleithoff,Armin Zittermann,Gero Tenderich,Heiner K. Berthold,Peter Stehle,Reiner Koerfer +5 more
TL;DR: Vitamin D(3) reduces the inflammatory milieu in CHF patients and might serve as a new antiinflammatory agent for the future treatment of the disease.
Journal ArticleDOI
Inflammatory Mediators and the Failing Heart Past, Present, and the Foreseeable Future
TL;DR: A review will summarize the tremendous growth of knowledge that has taken place in proinflammatory mediators in this field, with a focus on what the authors have learned from the negative clinical trials, as well as the potential direction of future research in this area.
Journal ArticleDOI
IL-10, IL-6, and TNF-α: Central factors in the altered cytokine network of uremia—The good, the bad, and the ugly
Peter Stenvinkel,Markus Ketteler,Richard J. Johnson,Bengt Lindholm,Roberto Pecoits-Filho,Miguel C. Riella,Olof Heimbürger,Tommy Cederholm,Matthias Girndt +8 more
TL;DR: Given the strong association between proinflammatory cytokines and complications common in end-stage renal disease, such as vascular calcification and wasting, the potential role of both general and targeted anticytokine treatment strategies in ESRD patients needs further evaluation.
References
More filters
Journal ArticleDOI
The meaning and use of the area under a receiver operating characteristic (ROC) curve.
TL;DR: A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented and it is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a random chosen non-diseased subject.
Journal ArticleDOI
Elevated Circulating Levels of Tumor Necrosis Factor in Severe Chronic Heart Failure
TL;DR: It is indicated that circulating levels of tumor necrosis factor are increased in cachectic patients with chronic heart failure and that this elevation is associated with the marked activation of the renin-angiotensin system seen in patients with end-stage cardiac disease.
Journal ArticleDOI
Wasting as independent risk factor for mortality in chronic heart failure.
Stefan D. Anker,Stefan D. Anker,Piotr Ponikowski,Susan Varney,T. P. Chua,Andrew L. Clark,Katharine Webb-Peploe,Derek Harrington,Wolfgang J. Kox,Philip A. Poole-Wilson,Andrew J.S. Coats +10 more
TL;DR: The cachectic state was predictive of 18-month mortality independent of age, NYHA class, left-ventricular ejection fraction, and peak oxygen consumption, and a subset of patients at extremely high risk of death was identified.
Journal ArticleDOI
Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: A report from the studies of left ventricular dysfunction (SOLVD)
Guillermo Torre-Amione,Samir R. Kapadia,Claude R. Benedict,Hakan Oral,James B. Young,Douglas L. Mann +5 more
TL;DR: Circulating levels of proinflammatory cytokines increase in patients as their functional heart failure classification deteriorates, and activation of the neurohumoral axis is unlikely to completely explain the elaboration of pro inflammatory cytokines in heart failure.
Journal ArticleDOI
Hormones regulating cardiovascular function in patients with severe congestive heart failure and their relation to mortality. CONSENSUS Trial Study Group.
TL;DR: There is a pronounced but variable neurohormonal activation in heart failure even in patients with similar clinical findings, and the effect of enalapril on mortality is related to hormonal activation in general and the renin-angiotensin system in particular.