Inflammatory Mediators and Clinical Outcome in Patients With Advanced Heart Failure Receiving Cardiac Resynchronization Therapy
| Autor: | Gregg C. Fonarow, William T. Abraham, Jagmeet P. Singh, Alan H. Kadish, Tamara B. Horwich, Ali F. Sonel, Alaa Shalaby, Li Yin Lee, John A. Belperio, John Gorcsan, Jasmina Halilovic, Malcolm M. Bersohn |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Time Factors Cardiac fibrosis medicine.medical_treatment Cardiomyopathy Cardiac resynchronization therapy 030204 cardiovascular system & hematology Proinflammatory cytokine Cardiac Resynchronization Therapy 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine medicine Humans Ventricular remodeling Aged Retrospective Studies Heart Failure Inflammation Ventricular Remodeling business.industry Stroke Volume Odds ratio medicine.disease Prognosis 030104 developmental biology Treatment Outcome Echocardiography Heart failure Cardiology Cytokines Intercellular Signaling Peptides and Proteins Female Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 117(4) |
| ISSN: | 1879-1913 |
| Popis: | Expression of different cytokines and growth factors after myocardial injury has been associated with fibroplasia and dilatation versus reverse remodeling and myocardial repair. Specifically, the proinflammatory/fibrotic mediators: interleukin (IL)-6, epidermal growth factor, and fibroblast growth factor (FGF)-2 cause fibroplasia, whereas reparative cytokines including: IL-1α, IL-1β, IL-4, and IL-13 can limit fibrosis. In appropriate patients, cardiac resynchronization therapy (CRT) reverses cardiomyopathy and improves outcome. However, a significant proportion will not respond to this therapy. We conducted this study to assess the association of proinflammatory/fibrotic and/or reparative immune response mediators at baseline with outcome after CRT. In the multicenter RISK study, plasma samples were collected prospectively before CRT implantation. Plasma IL-6, epidermal growth factor, FGF-2, IL-1α, IL-1β, IL-4, and IL-13 were evaluated by Luminex technology. The primary outcome was predefined as freedom from heart failure hospitalization or death and a decrease in echocardiographic end-systolic volume of >15% at 12 months. To determine associations with the outcome, multivariate logistic regression models including baseline clinical characteristics and the specific cytokines and growth factors were constructed. On multivariate analysis of 257 patients, detectable reparative cytokine IL-13 was significantly associated with the primary outcome (odds ratio 3.79; 95% CI 2.10 to 6.82, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect