Document Detail


Effects of thalidomide treatment in heart failure patients.
MedLine Citation:
PMID:  17106197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several studies have reported a direct association between elevated plasma levels of inflammatory cytokines and worse functional class (New York Heart Association [NYHA]) and cardiac function, measured as left ventricular ejection fraction (LVEF). Thalidomide has recently shown to improve LVEF in chronic heart failure patients, accompanied by a marked decrease in plasma levels of tumor necrosis factor alpha (TNF-alpha). METHODS: In a randomized prospective open label study of men and women with heart failure (HF) due to ischemic and non-ischemic cardiomyopathy who had systolic dysfunction (LVEF <40%) and NHYA classification, functional classes II and III were assigned to control (without thalidomide, 60 patients) or thalidomide group (20 patients). The initial dose of thalidomide was 100 mg once a day, and it was increased to 100 mg twice a day after a period of 10 days, if the prior dosage was well-tolerated. Demographic characteristics, etiology of HF, prior myocardial infarction, co-morbidities associated were registered and laboratory routine test, TNF-alpha serum levels, and echocardiogram were obtained at the beginning and after 6 months of follow-up. RESULTS: Clinical status (NYHA) at the end of the follow-up period, improved moderately in both groups. TNF-alpha levels were initially of 5.88 +/- 0.9 and 6.49 +/- 1.82 vs. 6.32 +/- 1.6 and 7.94 +/- 3.8 pg/ml during follow-up, for thalidomide and control groups, respectively. There were non-significant differences in echocardiography variables. CONCLUSION: In conclusion, although there is a large amount of information supporting a direct relationship between TNF-alpha and worsening of symptoms and prognosis in patients with HF and recently, the beneficial effect on thalidomide treatment has been suggested, these preliminary observations should be confirmed in a larger prospective study, specially trying to clarify the action mechanisms.
Authors:
Arturo Orea-Tejeda; Oscar Arrieta-Rodríguez; Lilia Castillo-Martínez; Tatiana Rodríguez-Reyna; Enrique Asensio-Lafuente; Julio Granados-Arriola; Joel Dorantes-García
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-11-09
Journal Detail:
Title:  Cardiology     Volume:  108     ISSN:  1421-9751     ISO Abbreviation:  Cardiology     Publication Date:  2007  
Date Detail:
Created Date:  2007-11-16     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  237-42     Citation Subset:  IM    
Copyright Information:
(c) 2007 S. Karger AG, Basel.
Affiliation:
Heart Failure Clinic, México City, Mexico.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cardiovascular Agents / therapeutic use*
Female
Heart Failure / blood,  drug therapy*
Humans
Male
Middle Aged
Prospective Studies
Thalidomide / therapeutic use*
Tumor Necrosis Factor-alpha / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 0/Tumor Necrosis Factor-alpha; 50-35-1/Thalidomide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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