PMID- 26264758
OWN - NLM
STAT- MEDLINE
DCOM- 20160908
LR  - 20151107
IS  - 1095-8584 (Electronic)
IS  - 0022-2828 (Linking)
VI  - 87
DP  - 2015 Oct
TI  - Lipopolysaccharide responsiveness is an independent predictor of death in 
      patients with chronic heart failure.
PG  - 48-53
LID - S0022-2828(15)30030-4 [pii]
LID - 10.1016/j.yjmcc.2015.07.029 [doi]
AB  - BACKGROUND: The origin of pro-inflammatory activation in chronic heart failure 
      (HF) remains a matter of debate. Lipopolysaccharide (LPS) may enter the blood 
      stream through the morphologically altered and leaky gut barrier. We hypothesized 
      that lower LPS reactivity would be associated with worse survival as compared to 
      normal or higher LPS reactivity. METHODS: LPS responsiveness was studied in 122 
      patients with chronic HF (mean+/-SD: age 67.3+/-10.3 years, 24 female, New York Heart 
      Association class [NYHA] class: 2.5+/-0.8, left ventricular ejection fraction 
      [LVEF]: 33.5+/-12.5%) and 27 control subjects of similar age (63.7+/-7.7 years, 
      p>0.05). Reference LPS was added at increasing doses to ex vivo whole blood 
      samples and necrosis factor-alpha (TNFalpha) was measured. Patients were subgrouped into 
      good- and poor-responder status according to their potential to react to 
      increasing doses of LPS (delta TNFalpha secretion). The optimal cut-off value was 
      calculated by receiver-operator characteristic curve (ROC) analysis. RESULTS: A 
      total of 56 patients with chronic HF died from any cause during follow-up. At 24 
      months, cumulative mortality was 16.4% (95% confidence interval 16.0-16.7%). The 
      delta TNFalpha value representing the optimal cut-off for the prediction of mortality 
      was 1522 pg/mL (24 months) with a sensitivity of 49.3% (95% confidence interval 
      37.2-61.4%) and specificity of 81.5% (95% confidence interval 61.9-93.6%). LPS 
      responder status remained an independent predictor of death after multivariable 
      adjustment (hazard ratio 0.09 for good- vs. poor-responders, 95% confidence 
      interval 0.01-0.67, p<0.05). CONCLUSIONS: LPS responsiveness in patients with 
      chronic HF is an independent predictor of death.
CI  - Copyright (c) 2015. Published by Elsevier Ltd.
FAU - Ebner, Nicole
AU  - Ebner N
AD  - Innovative Clinical Trials, University of Medicine Goettingen, Department of 
      Cardiology and Pneumology, Goettingen, Germany.
FAU - Foldes, Gabor
AU  - Foldes G
AD  - National Heart and Lung Institute, Imperial College London, UK.
FAU - Schomburg, Lutz
AU  - Schomburg L
AD  - Institute for Experimental Endocrinology, Charite Medical School, Campus 
      Virchow-Klinikum, Berlin, Germany.
FAU - Renko, Kostja
AU  - Renko K
AD  - Institute for Experimental Endocrinology, Charite Medical School, Campus 
      Virchow-Klinikum, Berlin, Germany.
FAU - Springer, Jochen
AU  - Springer J
AD  - Innovative Clinical Trials, University of Medicine Goettingen, Department of 
      Cardiology and Pneumology, Goettingen, Germany.
FAU - Jankowska, Ewa A
AU  - Jankowska EA
AD  - Laboratory for Applied Research on Cardiovascular System, Department of Heart 
      Diseases, Wroclaw Medical University, Wroclaw, Poland.
FAU - Sharma, Rakesh
AU  - Sharma R
AD  - National Heart and Lung Institute, Imperial College London, UK.
FAU - Genth-Zotz, Sabine
AU  - Genth-Zotz S
AD  - Katholisches Klinikum Mainz, Innere Medizin 1, Mainz, Germany.
FAU - Doehner, Wolfram
AU  - Doehner W
AD  - Centre for Stroke Research Berlin, Charite - University Medical School, Berlin, 
      Germany.
FAU - Anker, Stefan D
AU  - Anker SD
AD  - Innovative Clinical Trials, University of Medicine Goettingen, Department of 
      Cardiology and Pneumology, Goettingen, Germany.
FAU - von Haehling, Stephan
AU  - von Haehling S
AD  - Innovative Clinical Trials, University of Medicine Goettingen, Department of 
      Cardiology and Pneumology, Goettingen, Germany. Electronic address: 
      stephan.von.haehling@web.de.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150808
PL  - England
TA  - J Mol Cell Cardiol
JT  - Journal of molecular and cellular cardiology
JID - 0262322
RN  - 0 (Lipopolysaccharides)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Aged
MH  - Female
MH  - Heart Failure/*blood/mortality/pathology
MH  - Humans
MH  - Lipopolysaccharides/*blood
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Risk Factors
MH  - Tumor Necrosis Factor-alpha/*blood
MH  - Ventricular Function, Left/physiology
OTO - NOTNLM
OT  - Chronic heart failure
OT  - Immune system
OT  - Selenium
OT  - Tumor necrosis factor-alpha
EDAT- 2015/08/13 06:00
MHDA- 2016/09/09 06:00
CRDT- 2015/08/13 06:00
PHST- 2015/02/05 00:00 [received]
PHST- 2015/07/28 00:00 [revised]
PHST- 2015/07/30 00:00 [accepted]
PHST- 2015/08/13 06:00 [entrez]
PHST- 2015/08/13 06:00 [pubmed]
PHST- 2016/09/09 06:00 [medline]
AID - S0022-2828(15)30030-4 [pii]
AID - 10.1016/j.yjmcc.2015.07.029 [doi]
PST - ppublish
SO  - J Mol Cell Cardiol. 2015 Oct;87:48-53. doi: 10.1016/j.yjmcc.2015.07.029. Epub 
      2015 Aug 8.