Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure

Rauchhaus, Mathias; Doehner, Wolfram; Francis, Dárrel P.; Davos, Constantinos H.; Kemp, Michael; Liebenthal, Christa; Niebauer, Josef; Hooper, James; Volk, Hans Dieter; Coats, Andrew J.S.; Anker, Stefan D.

doi:10.1161/01.cir.102.25.3060

Cited by 697 publications

(254 citation statements)

References 24 publications

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“…Because this variable was skewed to the right, we created a binary variable using the cut point of ≥7 for the high deficiency category. This value was chosen because 25% of the sample had a score at or above this level; this type of dichotomy has been used previously with skewed clinical predictors of heart failure outcomes 25. Participants with fewer micronutrient deficiencies were classified as no to moderate deficiency .…”

Section: Methodsmentioning

confidence: 99%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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BackgroundDietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death.Methods and ResultsFour‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates.ConclusionsThis study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes.

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Section: Methodsmentioning

confidence: 99%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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“…RELAX included S‐HFpEF patients while DOSE and ROSE included acutely decompensated HF (ADHF) patients with both HFrEF and HFpEF. IL‐6, TNF‐α, and hs‐CRP were selected because of the long‐standing experience with their use in HF10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 and PTX3 because of its association with vascular inflammation21 and ability to risk‐stratify HF patients. Each trial was approved by the Institutional Review Board at each participating site, and all patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…A number of studies have revealed a significant correlation between elevations in blood levels of pro‐inflammatory biomarkers such as tumor necrosis factor alpha (TNF‐α), C‐reactive protein (CRP),interleukin 6 (IL‐6), and HF severity and prognosis 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20. Recently, pentraxin 3 (PTX3), an acute‐phase reactant member of the CRP super family expressed by a variety of cell types in response to various inflammatory stimuli21 and thought to be a marker of vascular inflammation, was found to facilitate risk stratification of HF patients 22, 23, 24, 25, 26.…”

Section: Introductionmentioning

confidence: 99%

Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction

Abernethy

Raza

Sun

et al. 2018

JAHA

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BackgroundUnderlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro‐inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD‐HFpEF) compared with patients with stable HFpEF (S‐HFpEF).Methods and ResultsUsing a post hoc analysis the serum biomarkers tumor necrosis factor‐alpha, high‐sensitivity C‐reactive protein interleukin 6 and pentraxin 3 (PTX3) and clinical, demographic, echocardiographic‐Doppler and clinical outcomes data were analyzed in HFpEF patients enrolled in NHLBI Heart Failure Research Network clinical trials which enrolled patients with either AD‐HFpEF or S‐HFpEF. Compared to S‐HFpEF, AD‐HFpEF patients had higher levels of PTX3 (3.08 ng/mL versus 1.27 ng/mL, P<0.0001), interleukin‐6 (4.14 pg/mL versus 1.71 pg/mL, P<0.0001), tumor necrosis factor‐alpha (11.54 pg/mL versus 8.62 pg/mL, P=0.0015), and high‐sensitivity C‐reactive protein (11.90 mg/dL versus 3.42 mg/dL, P<0.0001). Moreover, high‐sensitivity C‐reactive protein, interleukin‐6 and PTX3 levels were significantly higher in AD‐HFpEF compared with S‐HFpEF patients admitted for decompensated HF within the previous year. PTX3 was positively correlated with left atrial volume index (r=0.41, P=0.0017) and left ventricular mass (r=0.26, P=0.0415), while tumor necrosis factor‐alpha was inversely correlated with E/A ratio (r=−0.31, P=0.0395).ConclusionsLevels of pro‐inflammatory biomarkers are strikingly higher in AD‐HFpEF compared with S‐HFpEF patients. PTX3 and tumor necrosis factor‐alpha are correlated with echocardiographic‐Doppler evidence of diastolic dysfunction. Taken together these data support the concept that a heightened pro‐inflammatory state has a pathophysiologic role in the development of AD‐HFpEF.

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“…Interestingly, they found that tumor necrosis factor alpha levels were markedly increased in patients with end‐stage heart failure and renal impairment without being correlated to cardiac output or ventricular filling pressure, thus indicating prognosis rather than cardiac function. Several studies were since able to show that increased cytokine levels were related to a poor prognosis in patients with heart failure 4, 5, 6, 7…”

Section: Procalcitonin As a Prognostic Marker In Heart Failurementioning

confidence: 99%

The role of procalcitonin in acute heart failure patients

2017

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Acute dyspnoea is a common chief complaint in the emergency department and is mainly caused by cardiac and pulmonary underlying diagnoses. In patients with acute heart failure (AHF), an early initiation of adequate therapy is important to improve patient outcome. Clinical differentiation of pulmonary and cardiac underlying causes and of concomitant pathologies determines which therapeutic strategy is chosen.Procalcitonin is a marker of bacterial infection, which is markedly increased in AHF patients with concomitant bacterial infection and thus has the potential to guide the early initiation of adequate antibiotic therapy. The IMPACT‐EU trial is a multicenter randomized controlled trial designed to test this hypothesis.This mini‐review summarizes the current literature on procalcitonin in AHF and explains the design of the IMPACT‐EU trial.

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Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure

Abstract: sTNF-R1 was the strongest and most accurate prognosticator, independent of established markers of CHF severity. Assessment of sTNF-R1 may be useful in identifying patients who are at high risk of death and in monitoring patients undergoing anti-TNF-alpha treatment.

Cited by 697 publications

References 24 publications

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction

The role of procalcitonin in acute heart failure patients

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