PMID- 16368293
OWN - NLM
STAT- MEDLINE
DCOM- 20060331
LR  - 20131121
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 151
IP  - 1
DP  - 2006 Jan
TI  - The nonspecific anti-inflammatory therapy with methotrexate for patients with 
      chronic heart failure.
PG  - 62-8
AB  - BACKGROUND: Inflammatory mediators play an important role in the pathogenesis of 
      chronic heart failure (CHF). Methotrexate (MTX) is used in the treatment of 
      inflammatory-mediated diseases (eg, rheumatoid arthritis) because it modulates 
      the expression of numerous inflammatory cytokines. However, no studies have 
      assessed the effects of MTX on plasma levels of inflammatory mediators in 
      patients with CHF. METHODS: In a prospective, randomized, placebo-controlled, 
      single-blind study, 71 patients receiving conventional treatment were randomly 
      allocated to either MTX group (7.5 mg once a week, n = 35) or placebo group (n = 
      36) with a follow-up of 12 weeks. The effects of MTX on plasma cytokine 
      expression, left ventricular ejection fraction, left ventricular end-diastolic 
      dimension, New York Heart Association (NYHA) functional class, 6-minute walk test 
      distance, and quality of life (QOL) were determined in patients with CHF. 
      RESULTS: Sixty-two patients completed the study. The circulating levels of 
      inflammatory mediators in patients with CHF were markedly elevated compared with 
      healthy controls (P < or = .002). Methotrexate (n = 30) reduced plasma levels of 
      tumor necrosis factor alpha (-15.6%, P < .05), interleukin 6 (-21.8%, P < .01), 
      monocyte chemoattractant protein-1 (-22.6%, P < .01), soluble intercellular 
      adhesion molecule-1 (-19.2%, P < .05), and C-reactive protein (-27.2%, P < .01) 
      compared with baseline. Furthermore, interleukin 10 (15.8 %, P < .05) and soluble 
      IL-1 receptor antagonist (36.1%, P < .01) expression was increased, whereas 
      improvements in NYHA classification, 6-minute walk test distance, and QOL were 
      found compared with baseline. Monocyte chemoattractant protein-1 expression was 
      lower and soluble IL-1 receptor antagonist expression higher in the MTX than 
      placebo group (n = 32). Furthermore, the left ventricular ejection fraction, left 
      ventricular end-diastolic dimension, and incidence of main adverse cardiac events 
      between the 2 groups were similar. CONCLUSION: These results suggest that the 
      addition of MTX to conventional therapy for CHF has significant anti-inflammatory 
      effects and improves NYHA functional class, 6-minute walk test distance, and QOL.
FAU - Gong, Kaizheng
AU  - Gong K
AD  - Department of Cardiology, The First People's Hospital of Yangzhou, Yangzhou, 
      China. yungkzh@163.com
FAU - Zhang, Zhengang
AU  - Zhang Z
FAU - Sun, Xiaonin
AU  - Sun X
FAU - Zhang, Xin
AU  - Zhang X
FAU - Li, Aihua
AU  - Li A
FAU - Yan, Junfeng
AU  - Yan J
FAU - Luo, Qiuping
AU  - Luo Q
FAU - Gao, Yang
AU  - Gao Y
FAU - Feng, Yiliang
AU  - Feng Y
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Cytokines)
RN  - 0 (Inflammation Mediators)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
CIN - Am Heart J. 2006 May;151(5):e5; author reply e6-7. PMID: 16644306
MH  - Anti-Inflammatory Agents/adverse effects/*therapeutic use
MH  - Chronic Disease
MH  - Cytokines/blood
MH  - Female
MH  - Heart Failure/blood/*drug therapy
MH  - Humans
MH  - Inflammation Mediators/blood
MH  - Male
MH  - Methotrexate/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Prospective Studies
MH  - Single-Blind Method
EDAT- 2005/12/22 09:00
MHDA- 2006/04/01 09:00
CRDT- 2005/12/22 09:00
PHST- 2004/05/25 00:00 [received]
PHST- 2005/02/21 00:00 [accepted]
PHST- 2005/12/22 09:00 [pubmed]
PHST- 2006/04/01 09:00 [medline]
PHST- 2005/12/22 09:00 [entrez]
AID - S0002-8703(05)00216-4 [pii]
AID - 10.1016/j.ahj.2005.02.040 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Jan;151(1):62-8. doi: 10.1016/j.ahj.2005.02.040.