PP.36.08] EFFECT OF PROINFLAMMATORY CYTOKINES LEVEL IN PLASMA ON ENDOTHELIAL FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE

Abstract

Objective: The aim was to assess the impact of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels in plasma on endothelial function in patients with chronic heart failure (CHF). Design and method: The study included 56 patients with CHF functional class II by NYNA. CHF resulted from the background of ischemic heart disease and/or arterial hypertension. Group I consisted of 33 patients with endothelial dysfunction (36.4% men, 63.6% women), group II - 23 patients with normal endothelial function (34.8% men, 65.2% women). Patients underwent measurement of height and weight. Body mass index (BMI) was calculated. Assessment of endothelial function was conducted to determine the endothelium-dependent vasodilation (EDVD) by means of computer impedancometry on the brachial artery during the test with reactive hyperemia. EDVD was estimated as the maximal rate of blood filling (dz/dt max) as a percentage of the baseline blood filling. Value of dz/dt <12% was evaluated as an impairment of EDVD. The level of IL-6 and TNF-α in plasma was determined by ELISA assay. The range of normal values for IL-6 is 0–10 pg/mL for TNF-α - 0–6 pg/ml. Results: Mean age was 67,0 ± 6,5 and 68,2 ± 9,1 years, height - 165,5 ± 9,6 and 165,6 ± 11,0 cm, weight - 81,9 ± 15,5 and 79,5 ± 13,0 kg, BMI - 29,8 ± 3,8 and 29,1 ± 4,5 kg/m2 in group I and II, respectively. The average dz/dt in group I was −0,8 ± 14% in group II it was 20 ± 14% (p > 0.05). The average level of IL-6 and TNF-α in plasma in group I was 4,9 ± 3,2 pg/ml and 2,5 ± 6,5 pg/ml, in group II - 2,9 ± 1,1 pg/ml (p = 0.03) and 0.4 ± 0.5 pg/ml (p = 0.04), respectively. In both groups of patients we found negative correlation relationship between level of IL-6 in plasma and dz/dt (R = −0,38; p = 0.008) and between level of TNF-α in plasma and dz/dt (R = −0.34; p = 0.02). Conclusions: Patients with chronic heart failure with endothelial dysfunction have higher levels of inflammatory cytokines in blood plasma than in those with normal endothelial function. Changes in EDVD at computer impedancometry on the brachial artery with reactive hyperemia turned to be worse with increasing of IL-6 and TNF-α levels in plasma.