| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | International Journal of Cardiology | ||||
| Verlag: | ELSEVIER IRELAND LTD | ||||
| Ort der Veröffentlichung: | CLARE | ||||
| Band: | 103 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 2 | ||||
| Seitenbereich: | S. 182-186 | ||||
| Datum: | 2005 | ||||
| Institutionen: | Medizin > Lehrstuhl für Innere Medizin II | ||||
| Identifikationsnummer: |
| ||||
| Stichwörter / Keywords: | TUMOR-NECROSIS-FACTOR; IDIOPATHIC DILATED CARDIOMYOPATHY; INTERLEUKIN-6 GENE-TRANSCRIPTION; RANDOMIZED INTERVENTION TRIAL; SERUM INTERLEUKIN-6; METOPROLOL CR; FACTOR-ALPHA; MERIT-HF; CARVEDILOL; RAT; IL-6; chronic heart failure; beta-blockers | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 70531 |
Web of ScienceZusammenfassung
Background: In patients with severe heart failure (CHF), chronically elevated cytokine levels document a systemic inflammation. Experimental data suggest that activation of the beta-adrenergic system may participate in this inflammatory response. Herein, we studied as to whether beta-adrenergic blockade on top of standard CHIF therapy affects plasma cytokine levels (interleukin-6 [IL-6] and tumor ...
Zusammenfassung
Background: In patients with severe heart failure (CHF), chronically elevated cytokine levels document a systemic inflammation. Experimental data suggest that activation of the beta-adrenergic system may participate in this inflammatory response. Herein, we studied as to whether beta-adrenergic blockade on top of standard CHIF therapy affects plasma cytokine levels (interleukin-6 [IL-6] and tumor necrosis factor alpha [TNF alpha]). Moreover, we studied if beta-blocker related changes of these cytokines correspond to changes in left ventricular (LV) function and exercise capacity. Methods: In a prospective study, 21 patients with stable CHIF (NYHA functional class II-III, ejection fraction < 40%, mean age 57.6 +/- 12.4 years) were treated with captopril (100-150 mg/day), furosemide (40-120 mg/day), and/or digoxin (0.1-0.2 mg/day) for at least I month before they entered a 4 week run-in period in which dosages were kept unchanged. Metoprololsuccinate was administered in increasing dosages (up to 190 mg/day) for the following 3 months. Clinical, echocardiographic, spiroergometric, and biochemical changes were assessed at the start and the end of the run-in period as well as after 3 month of beta-blockade. Results: As compared to 2 10 healthy volunteers, CHF patients, prior to beta-blockade, presented with markedly elevated IL-6 (8.9 +/- 9.9 vs. 2.1 +/- 0.5 pg/ml: p < 0.05) and TNF alpha levels (1.51 +/- 0.49 vs. 0.64 +/- 0.15 pg/ml; p < 0.05) levels. In CHF patients, 3 month of beta-blockade lowered heart rate (84 14 vs. 68 12 bpm; p < 0.01), systolic (131 +/- 7 vs. 118 +/- 6 mm Hg; p < 0.01), and diastolic blood pressure (78 +/- 5 vs. 71 +/- 6 mm Hg;p < 0.01). Spiroergometric determined VO2 max (17.8 +/- 4.5 vs. 19.8 +/- 4.3 ml/min kg;p=0.013) increased significantly during 3 month of beta-blockade. Moreover, LV functional parameters tended to improve but the interindividual response varied and changes were non-significant. Interestingly, IL-6 levels decreased markedly during beta-blockade (8.9 +/- 9.9 vs. 4.5 +/- 3.1 pg/ml; p=0.036), whereas TNF alpha levels remained unchanged. Moreover, significant positive correlations were found between decrease of IL-6 levels and left ventricular end diastolic diameters (r(2)=0.59; p=0.012), whereas an inverse correlation was found between the decrease of IL-6 and the increase of VO2 max (r(2)=0.54; p=0.037), respectively. Conclusion: In heart failure patients, beta-blockade may lower IL-6 but not TNFa levels. Changes of IL-6 during beta-blockade may be related to changes of LV function and geometry. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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