European Journal of Heart Failure Advance Access originally published online on March 10, 2009
European Journal of Heart Failure 2009 11(4):378-385; doi:10.1093/eurjhf/hfp031
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Increased neutrophil lifespan in patients with congestive heart failure
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1 Division of Cardiology, Department of Internal Medicine, Research Center of Cardiovascular Biology, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
2 Casa Di Cura Istituto Cardiovascolare Camogli (ISC), Camogli, Italy
* Corresponding author. Tel: +103 537 545, Fax: +103 538 655, Email: gghiglio{at}unige.it
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Abstract |
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Aims: Congestive heart failure (CHF) can be thought of as a state of chronic immune activation. Polymorphonuclear neutrophil (PMN) apoptosis is one of the mechanisms responsible for the resolution of inflammation. A reduced PMN apoptotic rate in CHF patients may generate a persistent inflammatory response and hence mediate tissue damage in this group of patients. We aimed to measure levels of spontaneous apoptosis of circulating PMNs in CHF patients and in controls, and to examine whether NYHA class, left ventricular ejection fraction (LV-EF), and laboratory parameters of inflammation, endothelial damage, and of liver and renal function, could predict the rate of PMN apoptosis in CHF patients.
Methods and results: A total of 29 CHF patients and 26 controls were studied. Propidium iodide and flow cytometry were used to assess PMN apoptosis. Delay in PMN apoptosis was expressed as percentage (expressed as median, first and third quartiles) of surviving PMNs in the study subjects. We found an increased percentage of surviving PMNs [38(27.1–47.1)] in CHF patients compared with controls [19.4 (15.8–25.2)] (P < 0.05). The PMN survival rate in the CHF group was correlated to NYHA class, and plasma levels of C-reactive protein and alkaline phosphatase, while it was inversely correlated to LV-EF and protein levels. A positive relationship between PMN survival and increased ex vivo endothelial apoptosis was found.
Conclusion: Increased PMN lifespan in patients with worsening CHF could be used as a novel measurement of tissue and endothelial damage in this group of patients.
Key Words: Apoptosis • Neutrophils • Congestive heart failure • Neutrophil apoptosis • Endothelial apoptosis
Received February 5, 2009; Revised November 30, 2008; Accepted December 10, 2008
The first two authors contributed equally to the study.