© 2003 European Society of Cardiology
Transcardiac increase in tumor necrosis factor-
and left ventricular end-diastolic volume in patients with dilated cardiomyopathy
Department of Cardiovascular Medicine Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
* Corresponding author. Tel.: +81-775-48-2215; fax: +81-775-43-5839. E-mail address: tutamoto{at}belle.shiga-med.ac.jp
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Abstract |
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Background: It remains unclear whether tumor necrosis factor (TNF)-
and interleukin-6 (IL-6) are secreted from the failing heart and whether there is a relationship between the transcardiac gradients of these cytokines and left ventricular (LV) remodeling.
Aims: This study evaluated the relationship between transcardiac gradients of cytokines and LV volume and function in congestive heart failure patients with dilated cardiomyopathy (DCM).
Methods and results: We measured the plasma levels of TNF- and IL-6 in the aortic root (Ao) and the coronary sinus (CS) in 60 patients with DCM. There was no difference in plasma IL-6 between the Ao and the CS. However, the plasma TNF- level was significantly higher in the CS than that in the Ao. There was a significant correlation between the transcardiac gradient of plasma TNF- and the LV end-diastolic volume index (LVEDVI) and LV ejection fraction. According to stepwise multivariate analyses, the transcardiac increase of TNF- showed an independent and significantly positive relationship with a large LVEDVI.
Conclusions: These results indicate that the elevated plasma TNF- is partly derived from the failing heart in patients with DCM and that TNF- plays a potential role in structural LV remodeling in patients with DCM.
Key Words: Interleukin-6 • Tumor necrosis factor- • Dilated cardiomyopathy • Ventricular remodeling • Heart failure • Brain natriuretic peptide
Received June 27, 2003; Revised July 10, 2003; Accepted October 8, 2003
Presented in part at the scientific sessions of the American Heart Association, 2002.