Inflammatory cytokines and the possible immunological role for lipoproteins in chronic heart failure

Mathias Rauchhaus, Veronika Koloczek, Hans Dieter Volk, Michael Kemp, Josef Niebauer, Darrel P. Francis, Andrew J S Coats, Stefan D. Anker

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Aims: We studied the clinical and immunological importance of fasting cholesterol, HDL, LDL and triglycerides in patients with chronic heart failure in relation to plasma concentrations of tumor necrosis factor-α (TNFα), soluble TNF receptor-1 and -2 (sTNF-R1 and -R2), and a ratio potentially indicating recent endotoxin bioactivity (soluble [s] CD14/total cholesterol). Methods and results: Fifty-eight stable, non-oedematous patients with established heart failure and 19 controls were studied prospectively. Concentrations of sTNF-R1 and sCD14 were higher in patients than in controls (1238±96 vs. 632±72 pg/ml, P=0.005 and 3401±120 vs. 2775±139 pg/ml, P=0.007, respectively), whereas those of TNFα (9.3±1.1 vs. 6.7±0.6 pg/ml) and sTNF-R2 (2464±145 vs. 1920±303 pg/ml) were not. Cholesterol (5.6±0.1 vs. 5.5±0.2 mmol/l) and LDL (3.5±0.1 vs. 3.6±0.2 mmol/l) were not different (both P>0.75). Patients had lower HDL (1.10±0.04 vs. 1.4±0.06 mmol/l, P=0.0004) and higher triglycerides (2.1±0.1 vs. 1.1±0.1 mmol/l, P=0.0006). Aetiology and the presence of cardiac cachexia did not influence the lipid profile. Correlations in patients: cholesterol vs. TNFα (r=-0.40, P=0.003), vs. sTNF-R1 (r=-0.24, P=0.08), vs. sTNF-R2 (r=-0.29, P2 (P=0.07), NYHA class (P=0.08), aetiology (P=0.14), and age, body wasting, sodium, LVEF, heart rate, and blood pressure (all P>0.20, follow-up 12 months, event rate 26%). Conclusion: Our data supports previous findings that lower, rather than higher cholesterol levels are associated with poor clinical outcome in patients with chronic heart failure. This relationship is unrelated to heart failure aetiology, and suggests that the classic risk profile is not longer relevant in established heart failure. The little-recognised ability of all lipoprotein fractions to bind endotoxin and to serve as natural buffer substances may explain this relationship between lower lipoprotein levels, higher cytokine concentrations and impaired prognosis. Copyright (C) 2000 Elsevier Science Ireland Ltd.

Original languageEnglish
Pages (from-to)125-133
Number of pages9
JournalInternational Journal of Cardiology
Volume76
Issue number2-3
DOIs
Publication statusPublished - 2000

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Lipoproteins
Heart Failure
Cytokines
Tumor Necrosis Factor-alpha
Cholesterol
Endotoxins
Receptors, Tumor Necrosis Factor, Type II
Cachexia
Hypercholesterolemia
HDL Cholesterol
Fasting
Buffers
Triglycerides
Heart Rate
Sodium
Blood Pressure
Lipids

Keywords

  • Chronic heart failure
  • Cytokines
  • Endotoxin
  • Immune activation
  • Lipoproteins
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rauchhaus, M., Koloczek, V., Volk, H. D., Kemp, M., Niebauer, J., Francis, D. P., ... Anker, S. D. (2000). Inflammatory cytokines and the possible immunological role for lipoproteins in chronic heart failure. International Journal of Cardiology, 76(2-3), 125-133. https://doi.org/10.1016/S0167-5273(00)00224-2

Inflammatory cytokines and the possible immunological role for lipoproteins in chronic heart failure. / Rauchhaus, Mathias; Koloczek, Veronika; Volk, Hans Dieter; Kemp, Michael; Niebauer, Josef; Francis, Darrel P.; Coats, Andrew J S; Anker, Stefan D.

In: International Journal of Cardiology, Vol. 76, No. 2-3, 2000, p. 125-133.

Research output: Contribution to journalArticle

Rauchhaus, M, Koloczek, V, Volk, HD, Kemp, M, Niebauer, J, Francis, DP, Coats, AJS & Anker, SD 2000, 'Inflammatory cytokines and the possible immunological role for lipoproteins in chronic heart failure', International Journal of Cardiology, vol. 76, no. 2-3, pp. 125-133. https://doi.org/10.1016/S0167-5273(00)00224-2
Rauchhaus, Mathias ; Koloczek, Veronika ; Volk, Hans Dieter ; Kemp, Michael ; Niebauer, Josef ; Francis, Darrel P. ; Coats, Andrew J S ; Anker, Stefan D. / Inflammatory cytokines and the possible immunological role for lipoproteins in chronic heart failure. In: International Journal of Cardiology. 2000 ; Vol. 76, No. 2-3. pp. 125-133.
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AU - Francis, Darrel P.

AU - Coats, Andrew J S

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N2 - Aims: We studied the clinical and immunological importance of fasting cholesterol, HDL, LDL and triglycerides in patients with chronic heart failure in relation to plasma concentrations of tumor necrosis factor-α (TNFα), soluble TNF receptor-1 and -2 (sTNF-R1 and -R2), and a ratio potentially indicating recent endotoxin bioactivity (soluble [s] CD14/total cholesterol). Methods and results: Fifty-eight stable, non-oedematous patients with established heart failure and 19 controls were studied prospectively. Concentrations of sTNF-R1 and sCD14 were higher in patients than in controls (1238±96 vs. 632±72 pg/ml, P=0.005 and 3401±120 vs. 2775±139 pg/ml, P=0.007, respectively), whereas those of TNFα (9.3±1.1 vs. 6.7±0.6 pg/ml) and sTNF-R2 (2464±145 vs. 1920±303 pg/ml) were not. Cholesterol (5.6±0.1 vs. 5.5±0.2 mmol/l) and LDL (3.5±0.1 vs. 3.6±0.2 mmol/l) were not different (both P>0.75). Patients had lower HDL (1.10±0.04 vs. 1.4±0.06 mmol/l, P=0.0004) and higher triglycerides (2.1±0.1 vs. 1.1±0.1 mmol/l, P=0.0006). Aetiology and the presence of cardiac cachexia did not influence the lipid profile. Correlations in patients: cholesterol vs. TNFα (r=-0.40, P=0.003), vs. sTNF-R1 (r=-0.24, P=0.08), vs. sTNF-R2 (r=-0.29, P2 (P=0.07), NYHA class (P=0.08), aetiology (P=0.14), and age, body wasting, sodium, LVEF, heart rate, and blood pressure (all P>0.20, follow-up 12 months, event rate 26%). Conclusion: Our data supports previous findings that lower, rather than higher cholesterol levels are associated with poor clinical outcome in patients with chronic heart failure. This relationship is unrelated to heart failure aetiology, and suggests that the classic risk profile is not longer relevant in established heart failure. The little-recognised ability of all lipoprotein fractions to bind endotoxin and to serve as natural buffer substances may explain this relationship between lower lipoprotein levels, higher cytokine concentrations and impaired prognosis. Copyright (C) 2000 Elsevier Science Ireland Ltd.

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KW - Chronic heart failure

KW - Cytokines

KW - Endotoxin

KW - Immune activation

KW - Lipoproteins

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