Clinical Significance of TNFRSF1A36T/C Polymorphism in Cachectic Patients with Chronic Heart Failure

Abstract

We enrolled 142 CHF individuals who underwent cardiac and nutritional screening in order to assess cardiac performance and nutritional status. The relationship between TNFRSF1A rs767455 genotypes and patients’ features was investigated. Results: A greater distribution of the TT genotype among cachectic patients in contrast to non-cachectic individuals was found (TT frequencies of 62.9% and 37.1%, respectively; p = 0.013). We noted a significantly lower albumin concentration (p = 0.039) and higher C-reactive protein (CRP) levels (p = 0.019) in patients with the TT genotype. Regarding cardiac parameters, CHF individuals bearing the TT genotype demonstrated a significant reduction in ejection fraction (EF) (p = 0.033) in contrast to other genotype carriers; moreover, they had a significantly higher concentration of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the blood (p = 0.018). We also noted a lower frequency of TT genotype carriers among individuals qualified as grades I or II of the New York Heart Association (NYHA) (p = 0.006). The multivariable analysis selected the TT genotype as an unfavorable factor related to a higher chance of cachexia in CHF patients (Odds ratio (OR) = 2.56; p = 0.036). Conclusions: The rs767455TT genotype of TNFRSF1A can be considered as an unfavorable factor related to a higher risk of cachexia in CHF patients.

Usefulness of bioelectrical impedance analysis in assessment and monitoring of nutrition status of chronic heart failure patients

“…In the group of patients studied by the authors of the following study, patients with TT genotype had significantly lower blood albumin levels (p = 0.039), higher CRP levels (p = 0.012), and NT-proBNP (p = 0.015) in the blood serum, a higher percentage of NYHA grade III and IV (p = 0.006) and a higher incidence of moderate and severe malnutrition on the SGA scale (p = 0.022) compared to carriers of other genotypes. When BIA was performed in this group of patients, it was noted that TT carriers had significantly lower PA values compared to other genotype carriers (p = 0.035 and p = 0.032 for men and women, respectively) [25].…”

“…The latest studies indicate the possibility of combining BIA with the assessment of immunological parameters. Increased release of pro-inflammatory cytokines leads to the development of a generalized inflamma-tory process and disturbances in the metabolic functions of the organism associated with increased catabolism of muscles and/or adipose tissue, which may result in the development of malnutrition and cachexia [25]. TNF-α appears to play an important role in this process in patients with CHF, which exhibits its activity by binding to TNFR types 1 and 2 on the surface of various cell types, including myocardial fibroblasts, stimulating their proliferation.…”