Increased plasma adhesion molecule levels in patients with heart failure who have ischemic heart disease and dilated cardiomyopathy

Background Inflammatory mechanisms, including leukocyte activation, appear to play a pathogenetic role in the development of heart failure. Vascular c ell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICA M-1) are important mediators of leukocyte adhesion to vascular endothelium. The plasma levels of the soluble form of these molecules may be elevated i n chronic inflammation. Methods and Results We measured plasma VCAM-1 and ICAM-1 levels [in nanogra ms per milliliter) with the commercially available enzyme-linked immunosorb ent assay method in 12 patients (9 male, 3 female, aged 64 +/- 8 years) wit h dilated cardiomyopathy and heart failure, in 23 patients (23 mole, aged 6 5 +/- 9 years) with ischemic cardiomyopathy and heart failure, and in 11 he althly control subjects (8 male, 3 female, aged 49 +/- 14 years). Plasma IC AM-1 levels were higher both in patients with dilated cardiomyopathy (363 /- 77 ng/ml, P < .05) (mean +/- SEM) and in those with ischemic heart disea se (320 +/- 32 ng/ml, P < .05) than in control subjects (225 +/- 29 ng/ml). VCAM-1 levels were also higher in both groups with heart failure (664 +/- 73 ng/ml) than in control subjects (551 +/- 60 ng/ml). VCAM-1 levels were h igher in patients with class IV compared with those with class II and III h eart failure. Conclusions Plasma adhesion molecule levels ore increased in patients with heart failure and are unrelated to the presence or absence of angiographica lly demonstrable atherosclerotic coronary artery disease. The plasma level of VCAM-1 correlates with the severity of heart failure.