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Concentration of BNP, endothelin 1, pro-inflammatory cytokines (TNF-alpha, IL-6) and exercise capacity in patients with heart failure treated with carvedilol

Nessler, Jadwiga; Nessler, Bohdan; Kitlinski, Mariusz LU ; Gackowski, Andrzej; Piwowarska, Wiestawa and Stepniewski, Marek (2008) In Kardiologia Polska 66(2). p.144-153
Abstract
Background: Recent studies on the pathophysiology of heart failure indicate the role of neurohormones and immune and inflammatory processes as potential mechanisms involved in the pathogenesis and clinical course of chronic heart failure (CHF). Aim: To analyse the relationship between concentrations of brain natriuretic peptide (BNP), endothelin-1 (ET-1), inflammatory cytokines (TNF-alpha, IL-6) and cardiopulmonary stress test parameters, and to evaluate their changes during carvedilol treatment. Methods: The study included 86 patients (81 men and 5 women) aged from 35 to 70 years (56.8 +/- 9.19) with symptomatic heart failure and left ventricular ejection fraction < 40%, receiving an inhibitor of angiotensin II converting enzyme,... (More)
Background: Recent studies on the pathophysiology of heart failure indicate the role of neurohormones and immune and inflammatory processes as potential mechanisms involved in the pathogenesis and clinical course of chronic heart failure (CHF). Aim: To analyse the relationship between concentrations of brain natriuretic peptide (BNP), endothelin-1 (ET-1), inflammatory cytokines (TNF-alpha, IL-6) and cardiopulmonary stress test parameters, and to evaluate their changes during carvedilol treatment. Methods: The study included 86 patients (81 men and 5 women) aged from 35 to 70 years (56.8 +/- 9.19) with symptomatic heart failure and left ventricular ejection fraction < 40%, receiving an inhibitor of angiotensin II converting enzyme, diuretic and/or digoxin but not beta-blockers. All patients at baseline, and then at 3 and 12 months after treatment, underwent a panel of studies to assess functional capacity according to NYHA, echocardiographic and cardiopulmonary stress test (CPX) parameters, and serum concentrations of BNP, ET-1, TNF-alpha and IL-6. Before introducing carvedilol we found a weak relationship between concentrations of BNP, ET-1, IL-6 and decreased VO2 (peak). Results: At 12 months exercise tolerance was significantly improved (exercise stress testing prolonged by 143.9 s, p=0.001) and an increase in metabolic equivalent (MET) by 1.41 (p=0.001) was observed. The VO2 (peak) was nonsignificantly increased by a mean of 0.9 ml/kg/min. In patients with baseline VO2 (peak) < 14 ml/kg/min the concentrations of ET-1 and TNF-alpha were significantly higher than in the remaining ones, and after treatment they were significantly reduced. In these patients VO2 (peak)%N was also significantly increased (39.5 +/- 7.5 vs. 50.1 +/- 15,0; p=0.013). The number of patients with VO2 (peak) < 14 ml/kg/min also significantly decreased from 39 to 21 (p=0.013). Conclusions: In patients with HF decreased value of VO2 (peak) is associated with LV systolic function disorders and increased levels of BNP, ET-1, TNF-alpha and IL-6. Chronic treatment with carvedilol improves LV systolic function, exercise tolerance and peak oxygen consumption and is associated with significant decrease of BNP, ET-1, TNF-alpha and IL-6 concentrations. (Less)
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author
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Contribution to journal
publication status
published
subject
keywords
endothelia 1, BNP, exercise test, heart failure, cardiopulmonary exercise test, TNF-alpha, interleukin 6, carvedilol therapy
in
Kardiologia Polska
volume
66
issue
2
pages
144 - 153
publisher
Polskie Towarzystwo Kardiologiczne
external identifiers
  • wos:000255921700004
ISSN
1897-4279
language
English
LU publication?
yes
id
47aabaec-9fa5-4cfb-ba30-4fdc2ae2bfac (old id 1203326)
alternative location
http://www.termedia.pl/showpdf.php?article_id=9890&filename=concentration.pdf&priority=1
date added to LUP
2008-09-15 16:37:56
date last changed
2016-04-15 20:38:37
@article{47aabaec-9fa5-4cfb-ba30-4fdc2ae2bfac,
  abstract     = {Background: Recent studies on the pathophysiology of heart failure indicate the role of neurohormones and immune and inflammatory processes as potential mechanisms involved in the pathogenesis and clinical course of chronic heart failure (CHF). Aim: To analyse the relationship between concentrations of brain natriuretic peptide (BNP), endothelin-1 (ET-1), inflammatory cytokines (TNF-alpha, IL-6) and cardiopulmonary stress test parameters, and to evaluate their changes during carvedilol treatment. Methods: The study included 86 patients (81 men and 5 women) aged from 35 to 70 years (56.8 +/- 9.19) with symptomatic heart failure and left ventricular ejection fraction &lt; 40%, receiving an inhibitor of angiotensin II converting enzyme, diuretic and/or digoxin but not beta-blockers. All patients at baseline, and then at 3 and 12 months after treatment, underwent a panel of studies to assess functional capacity according to NYHA, echocardiographic and cardiopulmonary stress test (CPX) parameters, and serum concentrations of BNP, ET-1, TNF-alpha and IL-6. Before introducing carvedilol we found a weak relationship between concentrations of BNP, ET-1, IL-6 and decreased VO2 (peak). Results: At 12 months exercise tolerance was significantly improved (exercise stress testing prolonged by 143.9 s, p=0.001) and an increase in metabolic equivalent (MET) by 1.41 (p=0.001) was observed. The VO2 (peak) was nonsignificantly increased by a mean of 0.9 ml/kg/min. In patients with baseline VO2 (peak) &lt; 14 ml/kg/min the concentrations of ET-1 and TNF-alpha were significantly higher than in the remaining ones, and after treatment they were significantly reduced. In these patients VO2 (peak)%N was also significantly increased (39.5 +/- 7.5 vs. 50.1 +/- 15,0; p=0.013). The number of patients with VO2 (peak) &lt; 14 ml/kg/min also significantly decreased from 39 to 21 (p=0.013). Conclusions: In patients with HF decreased value of VO2 (peak) is associated with LV systolic function disorders and increased levels of BNP, ET-1, TNF-alpha and IL-6. Chronic treatment with carvedilol improves LV systolic function, exercise tolerance and peak oxygen consumption and is associated with significant decrease of BNP, ET-1, TNF-alpha and IL-6 concentrations.},
  author       = {Nessler, Jadwiga and Nessler, Bohdan and Kitlinski, Mariusz and Gackowski, Andrzej and Piwowarska, Wiestawa and Stepniewski, Marek},
  issn         = {1897-4279},
  keyword      = {endothelia 1,BNP,exercise test,heart failure,cardiopulmonary exercise test,TNF-alpha,interleukin 6,carvedilol therapy},
  language     = {eng},
  number       = {2},
  pages        = {144--153},
  publisher    = {Polskie Towarzystwo Kardiologiczne},
  series       = {Kardiologia Polska},
  title        = {Concentration of BNP, endothelin 1, pro-inflammatory cytokines (TNF-alpha, IL-6) and exercise capacity in patients with heart failure treated with carvedilol},
  volume       = {66},
  year         = {2008},
}