Increased endothelial monocyte adhesiveness is related to clinical outcomes in chronic heart failure.
BACKGROUND
Vascular inflammation and endothelial dysfunction are evident in patients with chronic heart failure (CHF). We hypothesized that circulating peripheral blood mononuclear cells (PBMCs) may be activated and the resultant increased endothelial monocyte adhesion may be functionally and pathophysiologically relevant in CHF. In the present study, we investigated the clinical significance of the activity of PBMCs in patients with CHF.


METHODS
PBMCs were isolated from 34 CHF patients, from 10 healthy volunteers (normal control group) and from 17 patients admitted for investigation of suspected coronary artery disease (disease control group). In each patient, the adhesiveness of PBMCs to cultured human aortic endothelial cells (HAECs) with or without tumor necrosis factor-alpha (TNF-alpha) stimulation was determined. Major adverse cardiac events (death, heart transplantation or hospitalization with worsening heart failure) were determined in the 34 CHF patients during a median follow-up period of 182 days.


RESULTS
Compared with those from both control groups and from mild CHF patients, PBMCs isolated from severe CHF patients adhered more to the HAECs. The endothelial adhesiveness of PBMCs correlated positively with the circulating levels of CAMs and can supply prognostic information in CHF patients. The difference between event-free curves based on the median levels of endothelial-PBMC adhesion was significant (log rank test, p=0.0139).


CONCLUSIONS
Endothelial adhesiveness of PBMCs is increased and correlated to clinical outcomes, and may be pathophysiologically relevant to the progression of CHF.
Yin
Wei-Hsian
WH
Division of Cardiology, Department of Internal Medicine, Cheng-Hsin Rehabilitation Medical Center, Taipei-Veterans General Hospital, Taiwan.
Chen
Jaw-Wen
JW
Young
Mason Shing
MS
Lin
Shing-Jong
SJ
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001011:Aorta / Q000166:cytology; D006328:Cardiac Catheterization; D015815:Cell Adhesion Molecules / Q000097:blood*; D002478:Cells, Cultured; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000494:pharmacology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology
D015815:Cell Adhesion Molecules; D019007:P-Selectin; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1