[Clinico-diagnostic significance of cytokine activation and changes of morphofunctional parameters of the heart in patients with chronic heart failure and possibilities of correction of revealed disturbances with simvastatin].
OBJECTIVE
To study clinico-diagnostic significance of cytokine activation, changes of levels of inflammatory cytokines in blood serum and main morphofunctional parameters of the heart in patients with chronic heart failure (CHF) of ischemic origin at the background of therapy with simvastatin.


METHODS
We examined 140 patients including 110 patients with clinical signs of I - IV functional class (FC) CHF and 30 healthy volunteers (control group). Standard transthoracic echocardiography was carried out in all patients at admission, in 3 and 6 months of follow up. Blood serum levels of cytokines 1beta, 6, 8 (IL-1beta, IL-6, IL-8), and tumor necrosis factor alpha (TNFalpha) were measured by solid phase immunoenzyme analysis at admission, on day 20, and in 3 and 6 months of follow up. The patients were randomized into 2 groups. Main group (n=60) consisted of patients who for 6 months in addition to basic therapy received simvastatin. Patients of comparison group (n=50) received standard therapy.


RESULTS
In patients with CHF elevation of proinflammatory cytokines (TNFalpha, IL-1beta, IL-6, IL-8) in blood serum was established. It progressed with growth of severity of CHF with maximal level of their elevation in patients with FC IV and in patients with unfavorable clinical outcome of the disease. At the background of therapy with simvastatin we noted significant lowering of proinflammatory cytokines (TNFalpha, IL-1beta, IL-6, IL-8) in blood serum irrespective of level of low density lipoprotein cholesterol, betterment of functional state of the left ventricle, positive clinical dynamics of CHF.
Rebrov
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Tolstov
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D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000494:pharmacology* / Q000627:therapeutic use*
D016207:Cytokines; D000960:Hypolipidemic Agents; D019821:Simvastatin