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Chronic systemic inflammation accompanies impaired ventricular diastolic function, detected by Doppler imaging, in patients with newly diagnosed systolic heart failure (Hellenic Heart Failure Study)

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Abstract

We sought to evaluate the relationship between plasma cytokine levels (sCD14, tumor necrosis factor [TNF]-α, and interleukin [IL]-6) and tissue Doppler derived indices of left ventricular systolic and diastolic function in patients with newly diagnosed heart failure. We enrolled 101 consecutive patients (mean age 65 ± 13 years) with newly diagnosed heart failure who were hospitalized in our institute. Echocardiographic assessment was performed in all patients during the third day of their initial hospitalization. The pulsed tissue Doppler imaging (TDI) of the systolic and diastolic function of mitral annulus was characterized by the systolic wave Smv, and the diastolic waves: Emv and Amv. Left atrial kinetic energy (LAKE), an index of left atrial function, was calculated using the equation 1/2 × LASV × 1.06 × Amv2; where LASV is left atrial systolic volume. Furthermore the ratio E/Emv and the flow propagation velocity were also calculated; where E is the rapid mitral filling wave, detected by pulse Doppler. Soluble plasma levels of CD14, TNF-α, and IL-6 were measured in all patients during their third day of hospitalization. Linear regression analysis, after adjustment for sex, age, left ventricular ejection function, body mass index, arterial hypertension, smoking, physical activity, creatinine clearance, diabetes mellitus, and blood lipid levels, revealed that IL-6 levels were inversely associated with LAKE (b = − 5422.4 ± 2031.5, P = 0.03), Sm (b= −0.375 ± 0.1, P = 0.03), and flow propagation (b = −5.404 ±0.621, P = 0.001). CD14 levels were inversely associated with flow propagation (b = −17.655 ±2.6, P = 0.001), and positively associated with E/Emv ratio (b = 2.58 ± 3.6, P = 0.002) and A/Amv ratio (b = 0.629 ± 0.6, P = 0.04). TNF-α was inversely associated with Smv (b−1.189 ± 0.3, P = 0.005). This study reveals that increased plasma levels of CD14, IL-6 and TNF-α are associated with impaired left atrial function and more advanced left ventricular diastolic and systolic dysfunction, in patients with newly diagnosed heart failure.

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References

  1. Ueland T, Aukrust P, Yndestad A, Otterdal K, Froland S, Dickstein K (2005) Soluble CD40 ligand in acute and chronic heart failure. Eur Heart J 26:1101–1107

    Article  PubMed  CAS  Google Scholar 

  2. Deswal A, Petersen N, Feldman A, Young J, White B, Mann D (2001) Cytokines and cytokines receptors in advanced heart failure. An analysis of the cytokines database from the Vesnarinone trial (VEST). Circulation 103:2055–2059

    PubMed  CAS  Google Scholar 

  3. Finkel MS, Oddis CV, Jacobs TD, Watkins SC, Hattler BG, Simmons RL (1991) Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science 257:387–389

    Article  Google Scholar 

  4. Hirota H, Yoshida K, Kishimoto T, Taga T (1995) Continuous activation of gp130, a signal-transducing receptor component for interleukin 6-related cytokines, causes myocardial hypertrophy in mice. Proc Natl Acad Sci USA 92:4862–4866

    Article  PubMed  CAS  Google Scholar 

  5. Kown KA, Page MT, Nguyen C, Zechner D, Gutierrez V, Comstock KL (1996) Tumor necrosis factor alpha induced apoptosis in cardiac myocytes. Involvement of the shingolipid signalling cascade in cardial cell death. J Clin Invest 98:2854–2865

    Article  Google Scholar 

  6. Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, Mann DL (2001) Cytokines and cytokines receptors in advanced heart failure. An analysis of the cytokine database from the Vesnarinone Trial (VEST) Circulation 103:2055–2059

    PubMed  CAS  Google Scholar 

  7. Koenig W, Khuseyinova N, Hoffmann MM (2002) CD14 C(-260) > T polymorphism, plasma levels of the soluble endotoxin receptor CD14, their association with chronic infections and risk of stable coronary artery disease. J Am Coll Cardiol 40:34–42

    Article  PubMed  CAS  Google Scholar 

  8. Anker SD, Egerer KR, Volk HD, Kox WJ, Poole-Wilson PA, Coats AJ (1997) Elevated Soluble CD1 4 Receptors and altered cytokines in chronic heart failure. Am J Cardiol 79:1426–1429

    Article  PubMed  CAS  Google Scholar 

  9. Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC (2003) Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The EuroHeart Failure survey program: a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 24:442–463

    Article  PubMed  CAS  Google Scholar 

  10. Appleton CP, Hatle LK, Popp RL (1998) Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 12:426–440

    Article  Google Scholar 

  11. Nagueh S, Middleton K, Koplen H, Zoghbi WA, Quiñones MA (1997) Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 30:1527–1533

    Article  PubMed  CAS  Google Scholar 

  12. Nieminen MS, Bohm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G (2005) Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology, Eur Heart J 26; 384–416

    Article  PubMed  Google Scholar 

  13. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  PubMed  CAS  Google Scholar 

  14. Dardas PS, Pitsis AA, Tsikaderis DD, Mezilis NE, Geleris PN, Boudoulas HK (2004) Left atrial volumes, function and work before and after mitral valve repair in chronic mitral regurgitation. J Heart Valve Dis 13:27–32

    PubMed  Google Scholar 

  15. Garcia MJ, Smedira NG, Greenberg NL, Main M, Firstenberg MS, Odabashian J (2000) Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation. J Am Coll Cardiol 35:201–208

    Article  PubMed  CAS  Google Scholar 

  16. Levine B, Kahnan I, Mayer L, Fillit HM, Packer M (1990) Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med 323:236–241

    PubMed  CAS  Google Scholar 

  17. Tsutamoto T, Hisanaga T, Fukai D, Wada A, Maeda Y, Kinoshita M (1995) Prognostic value of plasma soluble intercellular adhesion molecule-l and endothelin-1 concentration in patients with chronic congestive heart failure. Am J Cardiol 76:803–808

    Article  PubMed  CAS  Google Scholar 

  18. Terre-Amione G, Kapadia S, Lee J, Bies RD, Lebovitz R, Mann DL (1995) Expression and functional significance of tumor necrosis factor receptors in human myocardium. Circulation 92:1487–1493

    Google Scholar 

  19. Kapadia S, Lee J, Torre-Amione G, Birdsall HH, Ma TS, Mann DL (1995) Tumor necrosis factor-α gene and protein expression in adult feline myocardium after endotoxin administration. J Clin Invest 96:1042–1052

    Article  PubMed  CAS  Google Scholar 

  20. Mehra VC, Ramgolam VS, Bender JR (2005) Cytokines and cardiovascular disease J Leukoc Biol 78:805–818

    Article  PubMed  CAS  Google Scholar 

  21. Fukunaga T, Soejima H, Irie A, Sugamura K, Oe Y, Tanaka T, Kojima S, Sakamoto T, Yoshimura M, Nishimura Y, Ogawa H (2007) Expression of interferon-gamma and interleukin-4 production in CD4+ T cells in patients with chronic heart failure. Heart Vessels 22:178–183

    Article  PubMed  Google Scholar 

  22. Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, Mann DL (2001) Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST). Circulation 103:2055–2059

    PubMed  CAS  Google Scholar 

  23. Haudek SB, Taffet GE, Schneider MD, Mann DL (2007) TNF provokes cardiomyocyte apoptosis and cardiac remodeling through activation of multiple cell death pathways. J Clin Invest 117:2692–2701

    Article  PubMed  CAS  Google Scholar 

  24. Yu CM, Sanderson JE, Marwick TH, Oh JK (2007) Tissue Doppler imaging. A new prognosticator for cardiovascular diseases. J Am Coll Cardiol 49:1903–1914

    Article  PubMed  Google Scholar 

  25. Terzi S, Sayar N, Bilsel T, Enc Y, Yildirim A, Ciloğlu F, Yesilcimen K (2007) Tissue Doppler imaging adds incremental value in predicting exercise capacity in patients with congestive heart failure Heart Vessels 22:237–244

    Article  PubMed  Google Scholar 

  26. Prioli A, Marino P, Lanzoni L, Zardini P (1998) Increasing degrees of left ventricular filling impairment modulates left atrial function in humans. Am J Cardiol 82:756–761

    Article  PubMed  CAS  Google Scholar 

  27. Dernellis JM, Stefanadis CI, Zacharoulis AA, Toutouzas PK (1998) Left atrial mechanical adaptation to long-standing hemodynamic loads based on pressure-volume relations. Am J Cardiol 81:1138–1143

    Article  PubMed  CAS  Google Scholar 

  28. Terzi S, Dayi SU, Akbulut T, Sayas N, Bilsel, Tangurek B (2005) Value of left atrial function in predicting exercise capacity in heart failure with moderate to severe left ventricular systolic dysfunction. Int Heart J 46:123–131

    Article  PubMed  Google Scholar 

  29. Abe M, Oki T, Tabata T, Yamada H, Onose Y, Matsuoka M, Mishiro Y, Wakatsuki T, Ito S (1999) Evaluation of the hemodynamic relationship between the left atrium and left ventricle during atrial systole by pulsed tissue Doppler imaging in patients with left heart failure. Jpn Circ J 63:763–769

    Article  PubMed  CAS  Google Scholar 

  30. Chrysohoou C, Greenberg M, Pitsavos C, Panagiotakos DB, Ladis V, Barbetseas J, Brili S, Singh S, Stefanadis C (2006) Diastolic function in young patients with beta-thalassaemia major: An echocardiographic study. Echocardiography 23:38–44

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. First Cardiology Clinic, Hippokratio Hospital, University of Athens, Athens, Greece

    Christina Chrysohoou, Christos Pitsavos, John Barbetseas, Iason Kotroyiannis, Stella Brili, Karmen Vasiliadou, Lambros Papadimitriou & Christodoulos Stefanadis

  2. 46 Paleon Polemiston Street, Glyfada, 166-74, Greece

    Christina Chrysohoou

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  1. Christina Chrysohoou
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  2. Christos Pitsavos
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  3. John Barbetseas
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  4. Iason Kotroyiannis
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  6. Karmen Vasiliadou
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  8. Christodoulos Stefanadis
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Correspondence to Christina Chrysohoou.

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Chrysohoou, C., Pitsavos, C., Barbetseas, J. et al. Chronic systemic inflammation accompanies impaired ventricular diastolic function, detected by Doppler imaging, in patients with newly diagnosed systolic heart failure (Hellenic Heart Failure Study). Heart Vessels 24, 22–26 (2009). https://doi.org/10.1007/s00380-008-1080-7

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  • DOI: https://doi.org/10.1007/s00380-008-1080-7

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