Circulating cytokines and complements in chronic heart failure

Elevated levels of cytokines and complements have been reported in patients with advanced heart failure, but the exact clinical significance remains u nclear. Therefore, assessments correlated with hemodynamic and clinical var iables may provide important insight into the actions of cytokines and comp lements in chronic heart failure. The authors evaluated the clinical significance of cytokines and complement s. The study included 60 subjects (50 men, 10 women); 34 had idiopathic dil ated cardiomyopathy (DCM) and 26 had ischemic heart disease (IHD). Tumor ne crosis factor alpha and interleukin-2 receptor concentrations in chronic he art failure were greater than in control subjects (20.0 +/-0.4 vs 18.0 +/-0 .5 pg/mL, p<0.05 and 817.23 +/-63.50 vs 642.75 +/-27.31 pg/mL, p<0.05, resp ectively). There was no significant difference between DCM and IHD patients in circulating levels of the cytokines and the components complements (p = NS). Additionally, although functional classes III and IV heart failure pa tients showed a tendency to increase the levels of the cytokines and the co mponent complements, these differences were not statistically significant ( p = NS). Similarly, correlation analysis showed that the levels of the circ ulating cytokines and the component complements had independent value for m ortality. These results suggest that humoral and cellular immunity abnormal ities may play an important role in the pathogenesis of heart failure and d ilated cardiomyopathy.