Russian Heart Failure Journal 2009year Interrelation between levels of pro-inflammatory factors and severity of heart failure in ischemic heart disease


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2009/

Interrelation between levels of pro-inflammatory factors and severity of heart failure in ischemic heart disease

Belenkov Yu. N., Tatenkulova S. N., Mareev V. Yu., Masenko V. P., Balakhonova T. V., Tripoten M. I., Kaznacheeva E. I., Belyavsky E. A., Tkachev G. A., Zykov K. A.

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Urgency. Available literature data suggest that cytokines play an important role in the pathogenesis of inflammation in patients with IHD. However mechanisms underlying development of the inflammation response are not studied in detail; peculiarities of interrelations between components of the immune system are not established; and whether immune disorders are primary or secondary to the CHF pathogenesis in IHD is not known. Aim. Investigation of correlation of proinflammatory factors levels and CHF signs intensity in IHD patients. Materials and methods. Markers of endothelial and left ventricular function and immune activation were studied in 43 patients (41 men (95%) and 2 women (5%)) with I-IIb stage IHD and I–IV FC (NYHA) CHF. Age of patients ranged from 33 to 64 years. Blood levels of high-sensitivity C-reactive protein (hsCRP), immunoglobulins (IgG, IgA, IgM), sIL-2R, IL-8, IL-6, IL-18, IL-10, IFN-γ, NT-proBNP, endothelin (ET), and nitric oxide (NO) were measured. EchoCG was recorded using standard techniques with assessmen of LV systolic and diastolic function. Vasoregulatory endothelial function was studied using a reactive hyperemia (RH) test. Results. Patients were divided into two groups based on the NT-proBNP level. Group 1 included patients with NT-proBNP levels equal to or lower than median (725 pg/mL); Group 2 consisted of patients with NT-proBNP levels higher than median. An association of higher levels of proinflammatory factors (CRP, IL-6, NO metabolites) and severity of heart failure was observed. Endothelial dysfunction and impaired systolic and diastolic heart function were related to elevated markers of inflammation process (Group 1: CRP to ESR and EF; IL-18 to flow-dependent vasodilation and the diastolic function index, Decel time; Group 2: CRP to ESR; IFN-γ to EDV and Decel time). Therefore the data obtained have documented an association between elevated blood levels of inflammation markers and severity of heart failure.
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