[Role and significance of cytokines in the development of cardiac insufficiency].
The hypothesis of immune and inflammatory activation occurring during chronic cardiac failure, capable of maintaining the disease, is supported by many experimental and clinical trials. Plasma cytokines levels, particularly the tumour necrosis factor alpha (TNF alpha), are raised at advanced stages of the disease, especially in cachectic patients. The correlations with other, more traditional markers, especially neurohumoral, are not very close, probably suggesting different mechanisms. Cytokines are a group of very different molecules with multiple, non-specific, and even beneficial effects. However, the lack of regulation in severe cardiac failure may lead to deleterious effects on the heart. The experimental effects of TNF alpha (mini-pumps, transgenic animals) include features of myocarditis, chamber dilatation and contractile dysfunction. Large scale therapeutic trials of long acting TNF alpha antagonists could confirm the "inflammation hypothesis" of mutual interaction between cardiac failure and the production of cytokines.
Beck
L
L
Service de cardiologie, CHU Montpellier-Nîmes hôpital Gaston-Doumergue.
Messner-Pellenc
P
P
Davy
J M
JM
D002303:Cardiac Output, Low / Q000503:physiopathology*; D016207:Cytokines / Q000235:genetics / Q000502:physiology*; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D005810:Multigene Family; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha