Systemic inflammation and functional capacity in elderly heart failure patients.

Abstract

Elevated C-reactive protein (CRP) is associated with adverse outcomes in heart failure (HF) patients. Beta-blocker therapy may lower CRP levels. To assess if the changes of high-sensitivity (hs) CRP levels in HF patients over 12-week titration with beta-blockers correlate with functional capacity, plasma hs-CRP levels were measured in 488 HF patients [72.1 ± 5.31years, LVEF 40% (33/50)]. Hs-CRP, NT-proBNP and 6-min-walk-test (6MWT) were assessed at baseline and at week 12. Patients were divided based on hs-CRP changes (cut-off > 0.3mg/dl) into low-low (N = 225), high-high (N = 132), low-high (N = 54), high-low (N = 77) groups. At baseline, median hs-CRP concentration was 0.25 (0.12/0.53)mg/dl, NT-proBNP 551 (235/1455)pg/ml and average 6MWT distance 334 ± 105m. NT-proBNP changes were significantly different between the four hs-CRP groups (P = 0.011). NT-proBNP increased in the low-high group by 30 (- 14/88)pg/ml and decreased in the high-low group by - 8 (- 42/32)pg/ml. 6MWT changes significantly differed between groups [P = 0.002; decrease in the low-high group (- 18 ± 90m) and improvement in the low-low group (24 ± 62m)]. After beta-blocker treatment, hs-CRP levels are associated with functional capacity in HF patients. Whether this represents a potential target for intervention needs further study.