PMID- 11120695
OWN - NLM
STAT- MEDLINE
DCOM- 20010104
LR  - 20220410
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 102
IP  - 25
DP  - 2000 Dec 19
TI  - Plasma cytokine parameters and mortality in patients with chronic heart failure.
PG  - 3060-7
AB  - BACKGROUND: Inflammatory immune activation is an important feature in chronic 
      heart failure (CHF). Little is known about the prognostic importance of tumor 
      necrosis factor-alpha (TNF-alpha), soluble TNF-receptor 1 and 2 
      (sTNF-R1/sTNF-R2), interleukin-6 (IL-6), and soluble CD14 receptors (sCD14) in 
      CHF patients. METHODS AND RESULTS: In 152 CHF patients (age 61+/-1 years, New 
      York Heart Association [NYHA] class 2.6+/-0.1, peak VO(2) 17.3+/-0.6 mL. kg(-1). 
      min(-1), mean+/-SEM) plasma concentrations of immune variables were prospectively 
      assessed. During a mean follow-up of 34 months (>12 months in all patients), 62 
      patients (41%) died. Cumulative mortality was 28% at 24 months. In univariate 
      analyses, increased total and trimeric TNF-alpha, sTNF-R1, and sTNF-R2 (all 
      P</=0.0001), sCD14 (P=0.0007), and IL-6 (P=0.005) predicted 24-month mortality. 
      With multivariate analysis and receiver operating characteristics, sTNF-R1 
      emerged among all cytokine parameters as the strongest and most accurate 
      prognosticator in this CHF population, regardless of follow-up duration and 
      independently of NYHA class, peak VO(2), VE/VCO(2) slope, left ventricular 
      ejection fraction, and wasting (P<0.001). The receiver operating characteristic 
      area under the curve for sTNF-R1 was greater than for sTNF-R2 at 6, 12, and 18 
      months (all P<0.05). CONCLUSIONS: 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.
FAU - Rauchhaus, M
AU  - Rauchhaus M
AD  - Clinical Cardiology, National Heart and Lung Institute, Royal Brompton Hospital, 
      London, UK. mathias.rauchhaus@medizin.uni-halle.de
FAU - Doehner, W
AU  - Doehner W
FAU - Francis, D P
AU  - Francis DP
FAU - Davos, C
AU  - Davos C
FAU - Kemp, M
AU  - Kemp M
FAU - Liebenthal, C
AU  - Liebenthal C
FAU - Niebauer, J
AU  - Niebauer J
FAU - Hooper, J
AU  - Hooper J
FAU - Volk, H D
AU  - Volk HD
FAU - Coats, A J
AU  - Coats AJ
FAU - Anker, S D
AU  - Anker SD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Antigens, CD)
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 0 (Interleukin-6)
RN  - 0 (Lipopolysaccharide Receptors)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Receptors, Tumor Necrosis Factor, Type I)
RN  - 0 (Receptors, Tumor Necrosis Factor, Type II)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Antigens, CD/blood
MH  - Biomarkers/blood
MH  - Cardiac Output, Low/blood/*immunology/*mortality
MH  - Chronic Disease
MH  - Cytokines/*blood
MH  - Female
MH  - Humans
MH  - Immunoassay
MH  - Interleukin-6/blood
MH  - Lipopolysaccharide Receptors/blood
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - ROC Curve
MH  - Receptors, Tumor Necrosis Factor/blood
MH  - Receptors, Tumor Necrosis Factor, Type I
MH  - Receptors, Tumor Necrosis Factor, Type II
MH  - Solubility
MH  - Survival Analysis
MH  - Tumor Necrosis Factor-alpha/metabolism
EDAT- 2000/01/11 19:15
MHDA- 2001/02/28 10:01
CRDT- 2000/01/11 19:15
PHST- 2000/01/11 19:15 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/01/11 19:15 [entrez]
AID - 10.1161/01.cir.102.25.3060 [doi]
PST - ppublish
SO  - Circulation. 2000 Dec 19;102(25):3060-7. doi: 10.1161/01.cir.102.25.3060.