[Inflammation and endothelial dysfunction in patients with chronic heart failure].
BACKGROUND
In chronic heart failure (CHF), endothelial dysfunction (ED) is a consequence of an imbalance of vascular tone regulating substances. The relationship between ED and inflammation has not been fully investigated.


OBJECTIVE
To assess the association between inflammation and ED in CHF.


METHODS
Forty two patients aged 56+/-14 years (80% male) with a CHF in functional capacity II-III (New York Heart Association) and an ejection fraction (FE) <40% were consecutively studied. Patients were classified according to the presence or absence of ED, evaluated by reactive vasodilation measured by ultrasound, after brachial artery compression. Circulating levels of highly sensitive C reactive protein (usCRP), tumor necrosis factor a (TNFá) and interleukin-6 (IL-6) were determined by ELISA. A group of 15 healthy subjects of similar age, were studied as controls.


RESULTS
Sixty seven percent of patients had ED. Compared to controls, patients with CHF had higher usCRP (0.58+/-0.4 and 4.9+/-7.1 mg/dl respectively, p <0.01) and IL-6 (1.38+/-0.06 and 3.1+/-1.7 mg/dl respectively, p <0.01). Compared to patients without ED, patients with CHF and ED had higher levels of usCRP (3.0+/-0.4 and 6.0+/-5.7 mg/dl respectively, p <0.01) and TNFá (0.31+/-0.26 and 1.0+/-1.1 pg/ml, p =0.02). No differences in IL-6 were found between CHF groups.


CONCLUSIONS
In CHF patients, the presence of ED was associated with increased levels of inflammatory markers.
Greig
Douglas
D
Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Marcoleta 367, Santiago, Chile.
Castro
Pablo
P
Gabrielli
Luigi
L
Miranda
Rodrigo
R
Verdejo
Hugo
H
Alcaíno
Hernán
H
Bustos
Carlos
C
Chiong
Mario
M
Godoy
Iván
I
Mellado
Rosemarie
R
García
Lorena
L
Salas
Daniela
D
Vivar
Raúl
R
Vukasovic
José Luis
JL
Concepción
Roberto
R
Díaz-Araya
Guillermo
G