Time-course of changes in the levels of interleukin 6 in acutely decompensated heart failure.
BACKGROUND
Although cytokine elevation has been demonstrated in chronic heart failure, little attention has been focused on cytokine levels during the acute stage. We examined the changes of cytokine levels in patients with acutely decompensated heart failure to investigate their relationship with severity of heart failure.


METHODS
Patients with acutely decompensated heart failure (73 patients; 72+/-2 years) were included. Blood samples were taken from the peripheral vein on admission before the start of drug therapy, at 12, 24, 48 and 72 h as well as 1, 2 and 4 weeks after admission. Control data were obtained from age-matched normal patients who had no cardiovascular disease. Serum IL-6, IL-1beta and TNF-alpha levels were measured using the ELISA method.


RESULTS
Mean IL-6, IL-1beta and TNF-alpha levels on admission were significantly higher than those in the control patients (p<0.001). IL-6 peaked at 12 h and declined thereafter, whereas IL-1beta and TNF-alpha remained unchanged throughout the duration of the study. Peak IL-6 significantly correlated with pulmonary wedge pressure on admission (r=0.332, p=0.0041). % change of IL-6 levels between peak (12 h after admission) and 24 h was significantly correlated with that of pulmonary wedge pressure between peak (on admission) and 24 h (r=0.308, p=0.0081). Peak IL-6 in patients treated with mechanical ventilation on admission was significantly higher than that in patients who underwent no mechanical ventilation (p<0.05).


CONCLUSIONS
IL-6 levels possibly reflect the severity of heart failure and thus may be useful for the evaluation of disease status in acutely decompensated heart failure.
Suzuki
Hiroshi
H
The Third Department of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. hrsuzuki@med.showa-u.ac.jp
Sato
Ryuji
R
Sato
Takatoshi
T
Shoji
Makoto
M
Iso
Yoshitaka
Y
Kondo
Takeshi
T
Shibata
Masayuki
M
Koba
Shinji
S
Katagiri
Takashi
T
D000208:Acute Disease; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000628:therapy; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology; D011669:Pulmonary Wedge Pressure; D012121:Respiration, Artificial; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha