TUMOR-NECROSIS-FACTOR, NATURAL-KILLER ACTIVITY AND OTHER MEASURES OF IMMUNE FUNCTION AND INFLAMMATION IN ELDERLY MEN WITH HEART-FAILURE

Objective: To determine the status of tumor necrosis factor (TNF) and other measures of immunity and inflammation in chronic heart failure ( CHF) in the elderly. Design: Comparative survey study of subjects with heart failure and age-matched controls. Settings. University affiliat ed tertiary care VA Medical Center, Heart Failure Clinic. Patients: Tw enty men with New York Class II and III heart failure and 17 age-match ed controls. Interventions: None. Main outcome measure: Levels of lymp hocyte mitogenesis, TNF, natural killer (NK) cell activity, elastase-a lpha(1)-antitrypsin (E/alpha) and crosslinked fibrin D-dimers (XDP). R esults: TNF levels (p = 0.27), NK activity (p = 0.56), and lymphocyte mitogenesis (p = 0.67) were similar in patients and controls. E/alpha levels were somewhat lower in CHF patients (p = 0.05) and XDP were sim ilar (p = 0.59). However, TNF levels were significantly related to NK activity and to E/alpha activity in elderly men with heart failure but not controls. XDP were positively related to NK in heart failure pati ents but not controls. Conclusion: TNF and other measures of immune fu nction and inflammation do not appear to be significantly elevated in elderly patients with heart failure of moderate severity. However, sig nificant relationships exist between TNF, NK activity, XDP and E/alpha in the heart failure patients only, suggesting that immune activation and subclinical inflammation does exist in these patients.