Interleukin-6 correlates with hemodynamic impairment during dobutamine administration in chronic heart failure.
Proinflammatory cytokines have been implicated in the pathophysiology of chronic heart failure. We determined mixed venous levels of interleukin-6 (IL6) in 18 heart transplant candidates before, 1, 4, and 24 h after initiation of dobutamine infusion (3 micrograms/kg/min) during hemodynamic evaluation. During the first 4 h of dobutamine, systemic vascular resistance decreased (1358 to 1024 dyn x s x cm-5, P = 0.01) while cardiac index (2.3 to 2.9 l/min/m2, P = 0.008) increased. Both returned to baseline after 24 h. IL6 was elevated at baseline compared to age-matched controls (1.5 (0/4.3) vs. 0 (0/0.5) P = 0.003). There was an increase in IL6 from 1.5 (0/4.3) to 3.6 (0.3/5.3) pg/ml after 24 h (P = 0.04). We found higher IL6 levels in the sicker half of patients as defined by pulmonary capillary wedge pressure > 24 mmHg (P = 0.005), mean pulmonary arterial pressure > or = 35 mmHg (P = 0.01), right atrial pressure > 13 mmHg (P = 0.02), and heart rate > or = 87/min (P = 0.02) as well as mean arterial pressure < 82 mmHg (P = 0.005). In conclusion, in this pilot study IL6 correlates with the severity of chronic heart failure during low dose dobutamine infusion.
Deng
M C
MC
Department of Thoracic and Cardiovascular Surgery, Hospital of the Westfalian Wilhelms University, Muenster, Germany.
Erren
M
M
Lütgen
A
A
Zimmermann
P
P
Brisse
B
B
Schmitz
W
W
Assmann
G
G
Breithardt
G
G
Scheld
H H
HH
D000328:Adult; D002908:Chronic Disease; D004280:Dobutamine / Q000008:administration & dosage; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology
D015850:Interleukin-6; D004280:Dobutamine