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European Journal of Heart Failure 2006 8(2):141-146; doi:10.1016/j.ejheart.2005.05.010
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© 2006 European Society of Cardiology

Circulating levels of tumor necrosis factor-{alpha} correlate positively with severity of peripheral oedema in patients with right heart failure

Majed Odeha,c,*, Edmond Sabob,c and Arie Olivena,c

a Department of Internal Medicine B and, Bnai Zion Medical Center P.O. Box 6477, Haifa 31063, Israel
b Institute of Pathology, Carmel Medical Center Haifa, Israel
c Technion Faculty of Medicine, Israel Institute of Technology Haifa, Israel

* Corresponding author. Department of Internal Medicine B and, Bnai Zion Medical Center, P.O. Box 6477, Haifa 31063, Israel. Tel.: +972 4 8359775; fax: +972 4 8371393. E-mail address: majed.odeh{at}b-zion.org.il


  Abstract

Background: Several previous studies have shown that circulating levels of tumor necrosis factor-{alpha} (TNF) are elevated in patients with advanced congestive heart failure. However, the relationship between circulating levels of TNF and severity of peripheral oedema in these patients has not been previously evaluated.

Aims: To investigate the relationship between circulating levels of TNF, and severity of peripheral oedema in patients with right-sided heart failure (RHF).

Methods and results: Circulating levels of TNF were measured in 15 healthy volunteers, and in 83 patients with RHF with various levels of peripheral oedema. At presentation, 13 patients had no peripheral oedema (grade 0), 22 patients had mild peripheral oedema (grade 1), 23 patients had moderate peripheral oedema (grade 2), and 25 patients had severe peripheral oedema (grade 3). The values of circulating TNF levels (mean±S.E.M.) at presentation in the control group and in the RHF patients (oedema grades 0—3) were 2.98±0.21, 4.22±0.55, 4.67±0.29, 7.66±0.44, and 10.94±0.67 pg/mL respectively. There was a significant difference between the groups (p<0.0001, ANOVA), and a significant positive correlation was found between circulating TNF levels and severity of peripheral oedema (r=0.77, p<0.0001).

Conclusion: A significant relationship is present between circulating levels of TNF and severity of peripheral oedema in patients with RHF.

Key Words: Tumor necrosis factor-{alpha} • Peripheral oedema • Bowel-wall oedema • Congestive heart failure • Right-sided heart failure • Left-sided heart failure

Received February 5, 2005; Revised April 4, 2005; Accepted May 16, 2005


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