TY - JOUR
T1 - Plasma cytokine parameters and mortality in patients with chronic heart failure
AU - Rauchhaus, Mathias
AU - Doehner, Wolfram
AU - Francis, Darrel P.
AU - Davos, Constantinos
AU - Kemp, Michael
AU - Liebenthal, Christa
AU - Niebauer, Josef
AU - Hooper, James
AU - Volk, Hans Dieter
AU - Coats, Andrew J S
AU - Anker, Stefan D.
PY - 2000/12/19
Y1 - 2000/12/19
N2 - 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
AB - 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
KW - Heart failure
KW - Immune system
KW - Mortality
KW - Prognosis
KW - Proteins
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M3 - Article
C2 - 11120695
AN - SCOPUS:0034687595
VL - 102
SP - 3060
EP - 3067
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 25
ER -