Russian Heart Failure Journal 2008year Diagnostic potentialities of some neuro-humoral mediators in detection of left ventricular s ystolic dysfunction in IHD patients with heart failure


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2008/

Diagnostic potentialities of some neuro-humoral mediators in detection of left ventricular s ystolic dysfunction in IHD patients with heart failure

Volkova S. Yu.

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Urgency. Recent data have shown that development of left ventricular systolic dysfunction (LVSD) is closely related with activation of several neuro-humoral systems including those of natriuretic peptides and anti-inflammatory cytokines. Aim. To determine significance of plasma levels of several neuro-humoral mediators (NHM) such as NT-proBNP, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) for detection of LVSD in patients with IHD complicated with CHF. Materials and methods. Plasma levels of NT-proBNP, TNF-α and IL-6 were measured in 115 patients with IHD complicated with CHF, and obtained data were compared with assessments of heart structure and patient functional condition. Plasma levels of NHM were significantly higher in CHF patients with (n=84) and without LVSD (n=31) than in the comparison group (22 IHD patients with no clinical signs of CHF and with preserved LVEF). Results. Plasma levels of NT-proBNP and IL-6 were 2.5 and 7 times higher, respectively, than in patients with LVSD. Plasma levels of NT-proBNP higher than 1000 fmol / ml were associated with a more than 5.5 time increase in relative risk for LVSD in patients with CHF (RR=5.6 (1.4–30.0); р=0.0065). Plasma levels of IL-6 higher than 6.1 pg / ml were associated with 9 times increased relative risk for LVSD (RR=8.9 (2.3–35.4); р=0.00001). Plasma levels of TNF-α did not significantly differ in groups with and without LVSD. Patients with CHF and LVSD showed inverse correlations between plasma levels of NT-proBNP, IL-6 and LVEF as well as between NT-proBNP, IL-6 and results of 6‑min test. Plasma levels of NT-proBNP and IL-6 increased in accordance with CHF FC. Plasma level of TNF-α had no relationship with CHF FC.
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