The influence of aetiology on inflammatory and neurohumoral activation in patients with severe heart failure: A prospective study comparing Chagas' heart disease and idiopathic dilated cardiomyopathy
| Autor: | Edecio Cunha, Victor Sarli Issa, Amilcar O. Mocelin, Fernando Bacal, Edimar Alcides Bocchi, Guilherme Veiga Guimarães |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Cardiomyopathy Dilated Chagas Cardiomyopathy Male medicine.medical_specialty Heart disease medicine.medical_treatment Cardiomyopathy Receptors Tumor Necrosis Factor Internal medicine Natriuretic Peptide Brain Idiopathic dilated cardiomyopathy medicine Humans Prospective Studies fas Receptor Interleukin 6 Prospective cohort study Heart transplantation Neurotransmitter Agents biology Interleukin-6 Tumor Necrosis Factor-alpha business.industry Middle Aged medicine.disease Brain natriuretic peptide Survival Analysis Heart failure Cardiology biology.protein Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Heart Failure. 7:869-873 |
| ISSN: | 1388-9842 |
| Popis: | Patients with Chagas’ cardiomyopathy have the worst prognosis when compared to other aetiologies. It has been suggested that a more intense inflammatory activation could be responsible for this excessive mortality. We studied 35 patients with idiopathic dilated cardiomyopathy (IDC group) and 28 patients with Chagas’ heart disease (Chagas’ group) and 12 control subjects. We compared plasma tumor necrosis factor a (TNF-a), soluble TNF-a receptor type 1 (sTNF-R1), soluble Fas (sFas), interleukin 6 (IL-6), and brain natriuretic peptide type B (BNP) concentrations between the groups. TNF-a and IL-6 concentrations were higher in the IDC and Chagas groups as compared to controls (pb0.001 and p=0.001, respectively). sTNF-R1 concentration was higher in IDC after stratification for functional class (p=0.039), and there was a trend toward higher plasma TNF-a concentration in the Chagas’ group (p=0.092). IL-6 concentration was higher in Chagas than in IDC (p=0.005). Higher IL-6 levels were associated with worse outcome (p=0.03 for Chagas; p=0.003 for IDC). sFas concentration was similar among groups. BNP concentrations were higher in IDC (350 pg/ml) and in Chagas (444.6 pg/ml) as compared to the controls (20.3 pg/ml; pb0.01). Higher BNP levels were associated with death and heart transplantation in both aetiologies. Inflammatory activation in Chagas heart disease differs from IDC and is associated with heart failure severity. D 2004 European Society of Cardiology. Published by Elsevier B.V. |
| Databáze: | OpenAIRE |
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