Interleukin-6 Spillover in the Peripheral Circulation Increases With the Severity of Heart Failure, and the High Plasma Level of Interleukin-6 Is an Important Prognostic Predictor in Patients With Congestive Heart Failure

Autor: Takayoshi Tsutamoto, Tomoko Hisanaga, Masahide Sawaki, Atsuyuki Wada, Masahiko Kinoshita, Naoko Mabuchi, Daisuke Fukai, Keiko Maeda, Masato Ohnishi
Rok vydání: 1998
Předmět:
Adult
Male
medicine.medical_specialty
Sympathetic nervous system
Sympathetic Nervous System
Heart disease
Adrenergic beta-Antagonists
Femoral vein
Hemodynamics
Femoral artery
Muscle
Smooth
Vascular
Ventricular Function
Left
Norepinephrine
Internal medicine
medicine.artery
Blood plasma
medicine
Humans
Vasoconstrictor Agents
cardiovascular diseases
Sympathomimetics
Aged
Proportional Hazards Models
Aged
80 and over
Heart Failure
Neurotransmitter Agents
Ejection fraction
Endothelin-1
business.industry
Interleukin-6
Tumor Necrosis Factor-alpha
Stroke Volume
Femoral Vein
Middle Aged
medicine.disease
Prognosis
Femoral Artery
medicine.anatomical_structure
Heart failure
Case-Control Studies
Cardiology
Female
Endothelium
Vascular
business
Cardiology and Cardiovascular Medicine
Adrenergic alpha-Agonists
Atrial Natriuretic Factor
Follow-Up Studies
Forecasting
Zdroj: Journal of the American College of Cardiology. 31(2):391-398
ISSN: 0735-1097
DOI: 10.1016/s0735-1097(97)00494-4
Popis: Objectives. We 1) evaluated whether interleukin-6 (IL-6) is produced in the peripheral circulation in patients with congestive heart failure (CHF), 2) estimated the factors for increased IL-6, and 3) clarified the prognostic role of high plasma levels of IL-6 in patients with CHF.Background. Although plasma levels of IL-6 have been reported to increase in patients with CHF, and production of IL-6 in endothelial cells and vascular smooth muscle cells has been postulated from in vitro studies, the origin of the increase of IL-6 in CHF remains unknown. Moreover, the prognostic value of a high plasma level of IL-6, independent of classic neurohumoral factors, remains to be elucidated.Methods. A comparison was made of the plasma levels of IL-6 between the femoral artery and the femoral vein in 13 normal subjects and in 80 patients with CHF. In another study, we measured plasma IL-6 in 100 patients with CHF and follow-up data.Results. Plasma IL-6 levels increased significantly from the femoral artery to the femoral vein in normal subjects and in patients with CHF. Arteriovenous IL-6 spillover in the leg increased with the severity of CHF. Among the hemodynamic variables and the various neurohumoral factors, the plasma norepinephrine (NE) level showed an independent and significant positive relation with the plasma IL-6 level in patients with CHF. Moreover, treatment with beta-adrenergic blocking agents showed an independent and significant negative relation with plasma IL-6 levels. In 100 patients, plasma IL-6 (p < 0.0001), NE (p = 0.0004) and left ventricular ejection fraction (0.015) were significant independent prognostic predictors by Cox proportional hazards analysis.Conclusions. Our findings indicate that the IL-6 spillover in the peripheral circulation increases with the severity of CHF and that the increase in plasma IL-6 is mainly associated with the activation of the sympathetic nervous system. High plasma levels of IL-6 can provide prognostic information in patients with CHF, independent of left ventricular ejection fraction and plasma NE, suggesting an important role for IL-6 in the pathophysiology of CHF.
Databáze: OpenAIRE
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