PMID- 10072229
OWN - NLM
STAT- MEDLINE
DCOM- 19990325
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 83
IP  - 3
DP  - 1999 Feb 1
TI  - Effects of amiodarone on tumor necrosis factor-alpha levels in congestive heart 
      failure secondary to ischemic or idiopathic dilated cardiomyopathy.
PG  - 388-91
AB  - Tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis 
      of congestive heart failure and may be associated with an increase in mortality. 
      A recent in vitro study showed that amiodarone decreases TNF-alpha production by 
      human blood mononuclear cells in response to lipopolysaccharide. However, no 
      previous clinical studies have determined the effect of chronic amiodarone 
      therapy on TNF-alpha levels. Thus, the purpose of this study was to determine 
      whether amiodarone affects TNF-alpha levels in patients with ischemic and 
      nonischemic cardiomyopathy. TNF-alpha levels were analyzed by an enzyme-linked 
      immunoassay using plasma samples at baseline, 1, and 2 years of follow-up in New 
      York Heart Association class III patients (n = 40 in each of the placebo and 
      amiodarone groups, mean ejection fraction 0.25+/-0.09) who were randomized in the 
      Congestive Heart Failure-Survival Trial of Antiarrhythmic Therapy, a multicenter, 
      double-blind, placebo-controlled study in which the effect of amiodarone on 
      survival was investigated. TNF-alpha levels were elevated in both groups of 
      patients at baseline, 6.6+/-3.1 and 7.7+/-5.3 pg/ml in the amiodarone and placebo 
      groups, respectively (p = 0.3). There were no significant differences in 
      demographic or clinical variables between the 2 groups. Amiodarone treatment was 
      associated with a significant increase in TNF-alpha levels in patients with 
      ischemic cardiomyopathy, 12.7+/-12.5 and 6.8+/-3.7 pg/ml in the amiodarone and 
      placebo groups, respectively (p = 0.03) at 1 year. No change in TNF-alpha levels 
      was observed in patients with nonischemic cardiomyopathy. In contrast to the in 
      vitro data, amiodarone treatment is associated with an increase in TNF-alpha 
      levels in patients with ischemic cardiomyopathy. This increase is not associated 
      with an adverse effect on survival.
FAU - Oral, H
AU  - Oral H
AD  - Division of Cardiology, University of Michigan, Ann Arbor, USA.
FAU - Fisher, S G
AU  - Fisher SG
FAU - Fay, W P
AU  - Fay WP
FAU - Singh, S N
AU  - Singh SN
FAU - Fletcher, R D
AU  - Fletcher RD
FAU - Morady, F
AU  - Morady F
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Biomarkers)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - N3RQ532IUT (Amiodarone)
SB  - IM
MH  - Aged
MH  - Amiodarone/*therapeutic use
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Biomarkers/blood
MH  - Cardiomyopathy, Dilated/blood/*complications/drug therapy
MH  - Double-Blind Method
MH  - Electrocardiography
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Follow-Up Studies
MH  - Heart Failure/*blood/*drug therapy/etiology
MH  - Hemodynamics/drug effects
MH  - Humans
MH  - Myocardial Ischemia/blood/*complications/drug therapy
MH  - Prognosis
MH  - Prospective Studies
MH  - Survival Rate
MH  - Tumor Necrosis Factor-alpha/*metabolism
EDAT- 1999/03/11 00:00
MHDA- 1999/03/11 00:01
CRDT- 1999/03/11 00:00
PHST- 1999/03/11 00:00 [pubmed]
PHST- 1999/03/11 00:01 [medline]
PHST- 1999/03/11 00:00 [entrez]
AID - S0002-9149(98)00874-1 [pii]
AID - 10.1016/s0002-9149(98)00874-1 [doi]
PST - ppublish
SO  - Am J Cardiol. 1999 Feb 1;83(3):388-91. doi: 10.1016/s0002-9149(98)00874-1.