[Neurohormones and cytokines in heart failure. Correlation with coronary flow reserve].
OBJECTIVE
In heart failure, the coronary flow reserve (CFR) measured by positron-emission tomography (PET) is reduced. As neurohormone and cytokine levels are also altered in patients with the condition, our aim was to determine whether there is a correlation between CFR and neurohormone and cytokine levels.


METHODS
The study included 40 patients with heart failure but without ischemic heart disease. Myocardial blood flow was measured by PET using nitrogen-13 ammonia at baseline and during ATP infusion. The CFR was calculated for each patient. In addition, levels of the following were determined: norepinephrine, endothelin-1, angiotensin-II, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), tumor necrosis factor-alpha, interleukin (IL)-1beta, soluble IL-2 receptor, and IL-6.


RESULTS
All neurohormone levels were elevated above reference values. The levels of all cytokines, except IL-1beta, were also elevated. There was a significant negative correlation between CFR and the levels of several neurohormones: ANP (r=-0.476), BNP (r=-0.442), and IL-6 (r=-0.509).


CONCLUSIONS
In heart failure, the decrease in CFR is correlated with increases in the levels of certain neurohormones (i.e., ANP and BNP) and cytokines (i.e., IL-6), with vasodilatory effect. These increases are probably are related to compensatory mechanisms that are unable to correct for the endothelial dysfunction present in these patients.
Coma-Canella
Isabel
I
Servicio de Cardiología, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra, Pamplona, España. icoma@unav.es
Macías
Alfonso
A
Varo
Nerea
N
Sánchez Ibarrola
Alfonso
A
D003326:Coronary Circulation; D016207:Cytokines / Q000097:blood; D019332:Endothelin-1; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000276:immunology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood; D009638:Norepinephrine
D016207:Cytokines; D019332:Endothelin-1; D018377:Neurotransmitter Agents; D009638:Norepinephrine