Soluble tumor necrosis factor receptor levels identify a subgroup of heart failure patients with increased cardiomyocyte apoptosis.
BACKGROUND
We studied whether the presence of cardiomyocyte apoptosis (CA) in explanted failing hearts is related to previous exposure to the proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha).


METHODS
Serum levels of TNF-alpha and its soluble type two receptors (sTNFRII) were measured with ELISAs in 15 cardiac transplant recipients. CA was quantified with TUNEL assay in the explanted failing hearts and autopsy samples from six normal hearts.


RESULTS
The number of CA was significantly higher in explanted failing hearts than in normal hearts (0.041% vs. 0.007%, p<0.01). In heart failure patients, serum TNF-alpha was highly variable and did not correlate with CA. In contrast, serum sTNFRII showed a significant correlation (Pearson's r=0.74, p=0.002) with the amount of CA in explanted hearts. sTNFRII level >4500 pg/ml identified seven patients with 2.7 times higher percentage of CA than the other heart failure patients.


CONCLUSIONS
Increased levels of sTNFRII identify a heart failure patient subgroup with high CA activity.
Saraste
Antti
A
Department of Anatomy, University of Turku, Turku, Finland.
Voipio-Pulkki
Liisa-Maria
LM
Heikkilä
Päivi
P
Laine
Petri
P
Nieminen
Markku S
MS
Pulkki
Kari
K
D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000473:pathology*; D006333:Heart Failure / Q000097:blood* / Q000473:pathology*; D016027:Heart Transplantation; D006801:Humans; D007124:Immunoenzyme Techniques; D009206:Myocardium / Q000473:pathology*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D012995:Solubility; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D015415:Biomarkers; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha