Document Detail


Myocardial tumor necrosis factor-alpha expression does not correlate with clinical indices of heart failure in patients on left ventricular assist device support.
MedLine Citation:
PMID:  11789791     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mechanical unloading with a left ventricular assist device (LVAD) can improve clinical indices of heart failure and alter myocardial tumor necrosis factor-alpha (TNFalpha) expression, but a correlation between clinical and molecular indices has not been established. METHODS: We enrolled 14 patients with end-stage heart failure treated with drugs and mechanical unloading in a protocol including the collection of myocardial tissue samples at LVAD implantation and explantation. Ten nonfailing donor hearts served as controls. TNFalpha expression was measured by quantitative reverse transcription polymerase chain reaction. Clinical indices of heart failure were retrospectively analyzed and correlated with myocardial TNFalpha expression. RESULTS: Left ventricular end-diastolic dimension decreased (p < 0.01) and cardiac index (p < 0.001) increased with unloading. Abnormal values of serum sodium, creatinine, blood urea nitrogen, glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, and albumin showed a trend toward normalization with mechanical unloading. TNFalpha expression was increased in 5 of 14 patients and decreased with mechanical unloading in 4 of them. Surprisingly, there was no correlation between mRNA levels of TNFalpha and any of the clinical indices studied. CONCLUSIONS: Although clinical indices of heart failure improve and elevated levels of myocardial TNFalpha expression decrease with mechanical unloading, there is no correlation between the two. Thus, clinical and molecular indices of heart failure in LVAD-supported patients do not always correlate.
Authors:
P Razeghi; M Mukhopadhyay; T J Myers; J N Williams; C S Moravec; O H Frazier; H Taegtmeyer
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  72     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-14     Completed Date:  2002-01-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2044-50     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, The University of Texas-Houston Medical School, 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiomyopathies / diagnosis,  pathology,  surgery
Cohort Studies
Female
Gene Expression / physiology
Heart Failure / diagnosis,  pathology,  surgery*
Heart-Assist Devices*
Hemodynamics / physiology*
Humans
Male
Middle Aged
Myocardium / pathology*
RNA, Messenger / genetics
Reverse Transcriptase Polymerase Chain Reaction
Stroke Volume / physiology
Tumor Necrosis Factor-alpha / genetics*
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
R01-HL/AG 61483/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/RNA, Messenger; 0/Tumor Necrosis Factor-alpha

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