Document Detail


Do cytokines enable risk stratification to be improved in NYHA functional class III patients? Comparison with other potential predictors of prognosis.
MedLine Citation:
PMID:  11741364     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Elevated plasma levels of proinflammatory cytokines have been reported in patients with congestive heart failure. The purpose of this study was to assess whether cytokines improve risk stratification in a homogeneous group of NYHA class III patients with a left ventricular ejection fraction <40%. METHODS AND RESULTS: Plasma concentrations of big endothelin, tumour necrosis factor alpha, interleukins -1, -6, -10 and -12, sCD14 and GM-CSF were measured by ELISA in 91 NYHA III patients [mean (SD) age: 55 (10) years, 69% male, 34% coronary artery disease, 66% dilated cardiomyopathy] with a left ventricular ejection fraction and a peak oxygen uptake (peak VO2) of 19 (9)% and 12.1 (3.6) ml x min(-1) x kg(-1), respectively. During follow-up [22 (13) months], 31 patients (34%) died due to cardiovascular causes. In non-survivors, interleukin-6 was twice as high as in survivors [12.8 (16.9) pg x ml(-1)vs 5.6(5.3) pg x ml(-1), P<0.003], whereas plasma concentrations of the other cytokines showed no significant differences. Concerning long-term survival (> or =1 year), multivariate Cox regression analysis revealed an independent prognostic power for interleukin-6, which was further improved by combining with left ventricular ejection fraction and peak VO2, while for short-term survival (up to 6 months) interleukin-6 did not allow risk stratification. CONCLUSION: In NYHA class III patients, plasma concentrations of interleukin-6 are predictive of long-term survival. However, its value may be limited for clinical decision-making for cardiac transplantation (short-term survival).
Authors:
R Kell; A Haunstetter; T J Dengler; C Zugck; W Kübler; M Haass
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2001-12-19     Completed Date:  2002-03-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  70-8     Citation Subset:  IM    
Copyright Information:
Copyright 2001 The European Society of Cardiology.
Affiliation:
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Circadian Rhythm / physiology
Cytokines / blood*
Female
Follow-Up Studies
Germany / epidemiology
Heart Failure / blood,  diagnosis,  mortality
Humans
Male
Middle Aged
Multivariate Analysis
Oxygen / blood
Predictive Value of Tests
Prognosis
Risk Factors
Severity of Illness Index
Stroke Volume / physiology
Survival Analysis
Chemical
Reg. No./Substance:
0/Cytokines; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Eur Heart J. 2002 Jan;23(1):9-10   [PMID:  11741356 ]

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