The clinical relevance of circulating tumor necrosis factor-alpha in acute decompensated chronic heart failure without cachexia

Milani, R. V., Mehra, M. R., Endres, S., Eigler, A., Cooper, S., Lavie, C. J. and Ventura, H. O. (1996) The clinical relevance of circulating tumor necrosis factor-alpha in acute decompensated chronic heart failure without cachexia. Chest, 110 4: 992-995. doi:10.1378/chest.110.4.992


Author Milani, R. V.
Mehra, M. R.
Endres, S.
Eigler, A.
Cooper, S.
Lavie, C. J.
Ventura, H. O.
Title The clinical relevance of circulating tumor necrosis factor-alpha in acute decompensated chronic heart failure without cachexia
Journal name Chest   Check publisher's open access policy
ISSN 0012-3692
1931-3543
Publication date 1996-10
Sub-type Article (original research)
DOI 10.1378/chest.110.4.992
Volume 110
Issue 4
Start page 992
End page 995
Total pages 4
Place of publication Northbrook, IL, United States
Publisher American College of Chest Physicians
Language eng
Formatted abstract
Study objective: To evaluate the clinical relevance of circulating tumor necrosis factor-α (TNFα) in subjects with advanced acutely decompensated congestive heart failure (CHF) and to determine the modulatory effect of clinical interventions on short-term elaboration of this cytokine.

Design: Prospective, ease-controlled study. Setting: Inpatient and outpatient (hospital and clinic), at regional academic medical center.

Patient interventions: Plasma concentrations of TNFα were determined in 25 healthy, normal control subjects and in 29 noncachectie patients with advanced CHF (mean ejection fraction=16±6%) who required hospitalization for IV diuretic and/or inotropic therapy despite optimization of oral medical regimens. CHF patients were divided into two groups: diuretic responsive (group A; n=6) and diuretic resistant requiring inotropic support (group B; n=23). Group B was randomly allocated to receive either IV dobutamine (n=13) or milrinone (n=10) for 72 h. TNFα levels in CHF patients were measured serially at baseline, at 6 h, at 48 h, at 72 h, and at 1-week follow-up after hospital discharge.

Results: Plasma TNFα levels at baseline in CHF patients were 4.0± 1.1 pg/mL (range, 0.5 to 6.5 pg/mL) and 2.5±0.6 pg/mL (range, 0.5 to 6.8 pg/mL) in groups A and B, respectively, which were significantly different (p<0.002) from normal subjects (0.89±0.40 pg/mL; range, 0.5 to 9.7 pg/mL). Despite clinically successful therapy with IV diureties, dobutamine, or milrinone, plasma levels of this cytokine remained unchanged. Plasma TNFα in CHF patients measured in recovery (1 week after hospital discharge) was 5.1±1.2 pg/mL (range, 1.0 to 9.9 pg/mL) and 3.9±0.8 pg/mL (range, 0.5 to 8.7 pg/mL) in groups A and B, respectively.

Conclusion: These findings suggest that although noncachectic patients with chronic heart failure who suffer acute decompensation elaborate significantly higher circulating levels of TNFα compared with healthy control subjects, no significant reduction or alteration in circulating TNFα is noted in the short-term follow-up despite clinical improvement.
Keyword Cytokines
Heart failure
Inotropes
Tumor necrosis factor
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:36:43 EST