[Effect of carvedilol on blood levels of cytokines and symptoms of heart failure in patients with postinfarction cardiac dysfunction.].
Effect of 6 months treatment with carvedilol (25 mg/day) on blood levels of cytokines (interleukins 1alpha, 2, 6, 8, tumor necrosis factor alpha) and clinical symptoms of heart failure was studied in patients with cardiac dysfunction after myocardial infarction. Patients with NYHA class II heart failure, ejection fraction 50% and moderately lowered tolerance to physical exercise (n=21) initially had enhanced cytokine expression: blood content of interleukin (IL) 2 was 2.8 times, tumor necrosis factor (TNFalpha) 78%, IL-1alpha 60% above normal level. Therapy with carvedilol in this group was associated with decreases of Il-2 (-23.8%), TNFalpha (-16.7%), IL-1alpha (-12.5%) (p<0.05-0.01). This was accompanied by alleviation of clinical symptoms and improved exercise tolerance. Patients with NYHA class III heart failure (n=16) with low left ventricular ejection fraction (30+/-2.7%) and low exercise tolerance had high levels of all studied cytokines. Levels of IL-2, TNFalpha and IL-1alpha were most elevated (3.1, 2.8 and 2 times higher than normal values, respectively). Therapy with carvedilol was associated with improvement of clinical symptoms and exercise tolerance (+35%, p<0.05)), increase of ejection fraction (+15%, p<0.05), decrease of left ventricular end systolic volume (-17.5%, p<0.05), and lowering of blood levels of TNFalpha (-31%), IL-2 (-17.4%), IL-1alpha (-15.6%). However cytokine levels remained substantially elevated compared with normal values. Carvedilol was well tolerated, and did not cause negative metabolic effects or other complications.
Research Institute for Cardiology of the Research Centre of RAMS Siberian Branch; ul. Kievskaya 111, 634012 Tomsk, Russia.
A T
AT
Tepliakov
M M
MM
Dibirov
L A
LA
Bolotskaia
T A
TA
Stepacheva
E Iu
EIu
Pushnikova
N V
NV
Karaman
E V
EV
Malakhovich
S E
SE
Mamchur
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood; D017079:Exercise Tolerance / Q000187:drug effects; D006333:Heart Failure; D006801:Humans; D016277:Ventricular Function, Left / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D016207:Cytokines