Transcardiac increase in tumor necrosis factor-alpha and left ventricular end-diastolic volume in patients with dilated cardiomyopathy.
BACKGROUND
It remains unclear whether tumor necrosis factor (TNF)-alpha and interleukin-6 (IL-6) are secreted from the failing heart and whether there is a relationship between the transcardiac gradients of these cytokines and left ventricular (LV) remodeling.


OBJECTIVE
This study evaluated the relationship between transcardiac gradients of cytokines and LV volume and function in congestive heart failure patients with dilated cardiomyopathy (DCM).


RESULTS
We measured the plasma levels of TNF-alpha and IL-6 in the aortic root (Ao) and the coronary sinus (CS) in 60 patients with DCM. There was no difference in plasma IL-6 between the Ao and the CS. However, the plasma TNF-alpha level was significantly higher in the CS than that in the Ao. There was a significant correlation between the transcardiac gradient of plasma TNF-alpha and the LV end-diastolic volume index (LVEDVI) and LV ejection fraction. According to stepwise multivariate analyses, the transcardiac increase of TNF-alpha showed an independent and significantly positive relationship with a large LVEDVI.


CONCLUSIONS
These results indicate that the elevated plasma TNF-alpha is partly derived from the failing heart in patients with DCM and that TNF-alpha plays a potential role in structural LV remodeling in patients with DCM.
Department of Cardiovascular Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan. tutamoto@belle.shiga-med.ac.jp
Takayoshi
T
Tsutamoto
Atsuyuki
A
Wada
Masato
M
Ohnishi
Takashi
T
Tsutsui
Chitose
C
Ishii
Keijin
K
Ohno
Masanori
M
Fujii
Takehiro
T
Matsumoto
Takashi
T
Yamamoto
Tomoyuki
T
Takayama
Tomohiro
T
Dohke
Minoru
M
Horie
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000628:therapy; D016022:Case-Control Studies; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis* / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D013148:Spironolactone / Q000627:therapeutic use; D013318:Stroke Volume; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000096:biosynthesis* / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D000806:Angiotensin-Converting Enzyme Inhibitors; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D013148:Spironolactone; D005665:Furosemide