Plasma cytokine parameters and mortality in patients with chronic heart failure

Mathias Rauchhaus, Wolfram Doehner, Darrel P. Francis, Constantinos Davos, Michael Kemp, Christa Liebenthal, Josef Niebauer, James Hooper, Hans Dieter Volk, Andrew J S Coats, Stefan D. Anker

Research output: Contribution to journalArticlepeer-review

Abstract

Background - Inflammatory immune activation is an important feature in chronic heart failure (CHF). Little is known about the prognostic importance of tumor necrosis factor-α (TNF-α), soluble TNF receptor 1 and 2 (sTNF-R1/sTNF-R2), interleukin-6 (IL-6), and soluble CD14 receptors (sCD14) in CHF patients. Methods and Results - In 152 CHF patients (age 61±1 years, New York Heart Association [NYHA] class 2.6±0.1, peak VO2 17.3±0.6 mL·kg-1·min-1, mean±SEM) plasma concentrations of immune variables were prospectively assessed. During a mean follow-up of 34 months (> 12 months in all patients), 62 patients (41%) died. Cumulative mortality was 28% at 24 months. In univariate analyses, increased total and trimeric TNF-α, sTNF-R1, and sTNF-R2 (all P≤0.0001), sCD14 (P=0.0007), and IL-6 (P=0.005) predicted 24-month mortality. With multivariate analysis and receiver operating characteristics, sTNF-R1 emerged among all cytokine parameters as the strongest and most accurate prognosticator in this CHF population, regardless of follow-up duration and independently of NYHA class, peak VO2, VE/VCO2 slope, left ventricular ejection fraction, and wasting (P

Original languageEnglish
Pages (from-to)3060-3067
Number of pages8
JournalCirculation
Volume102
Issue number25
Publication statusPublished - Dec 19 2000

Keywords

  • Heart failure
  • Immune system
  • Mortality
  • Prognosis
  • Proteins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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