L. Liu et Sp. Zhao, The changes of circulating tumor necrosis factor levels in patients with congestive heart failure influenced by therapy, INT J CARD, 69(1), 1999, pp. 77-82
Citations number
27
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Recent studies suggest that tumor necrosis factor-alpha (TNF-alpha) plays a
n important role in the pathogenesis of congestive heart failure and that d
rugs used in the treatment of heart failure have modulation effects on the
production of TNF-alpha. To examine an alteration of circulating TNF-alpha
concentration in patients with severe chronic heart failure after improving
heart function and investigate the influence of agents on circulating TNF-
alpha concentrations, we measured the plasma levels of TNF-alpha by enzyme
linked immunoabsorbent assay in 31 patients and evaluated their heart funct
ions before and after 72 h of therapy. The results showed that circulating
TNF-alpha concentrations significantly decreased after therapy (from 124.36
+/-14.85 pg/ml to 93.84+/-13.57 pg/ml, P<0.001). The circulating TNF-alpha
concentrations of patients (n=22) whose heart function was improved one cla
ss or more after therapy declined significantly (from 127.51+/-20.78 pg/ml
to 91.54+/-18.56 pg/ml, P<0.01) but this situation did not exist in patient
s (n=9) whose heart functions had no or little improvement. All patients we
re divided into three groups according to their management: 'group A' (n=14
) who received milrinone and angiotensin-converting enzyme inhibitors (ACEI
), 'group B' (n=6) who received milrinone but not ACEI and 'group C' (n=11)
who received ACEI and dobutamine but not milrinone. The circulating TNF-al
pha concentration of patients in group A significantly declined (from 126.6
8+/-26.04 pg/ml to 95.92+/-24.79 pg/ml, P<0.01). No statistical significanc
e of change of TNF-alpha concentration was found in patients in group B or
group C, although a tendency of decline existed (from 119.92+/-34.72 pg/ml
to 84.33+/-30.70 pg/ml and from 123.83+/-19.50 pg/ml to 96.37+/-16.62 pg/ml
, respectively). These findings support that decreased plasma TNF-alpha lev
el accompanies the improvement of heart function. This phenomenon may be ex
plained by the special abilities of agents, such as ACEI and milrinone, to
inhibit the TNF-alpha production. (C) 1999 Elsevier Science Ireland Ltd. Al
l rights reserved.