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Endothelial function and proinflammatory cytokines in patients with ischemic heart disease and dilated cardiomyopathy

Costas Tentolouris1, Dimitris Tousoulis, Charalambos Antoniades

  • 1Cardiology Units, Hippokration Hospital, Athens University Medical School, 69 S. Karagiorga, 16675 Athens, Greece.

International Journal of Cardiology
|April 20, 2004
PubMed

Insights

Heart failure patients show impaired endothelial function and higher inflammation markers, with ischemic heart failure exhibiting greater dysfunction than dilated cardiomyopathy, suggesting atherosclerosis plays a role.

Area of Science:

  • Cardiology
  • Immunology
  • Vascular Biology

Background:

  • Proinflammatory cytokines like tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) are key in immune responses and linked to endothelial dysfunction in coronary artery disease (CAD) and heart failure.
  • Endothelial dysfunction is a critical factor in cardiovascular diseases.

Purpose of the Study:

  • To compare endothelial function and levels of IL-6 and TNF-alpha in patients with ischemic heart failure, dilated cardiomyopathy, CAD, and healthy controls.
  • To investigate the relationship between inflammation and endothelial dysfunction in different heart failure etiologies.

Main Methods:

  • Enrolled 20 dilated cardiomyopathy, 48 ischemic cardiomyopathy, 26 CAD, and 14 healthy control participants.
  • Measured forearm blood flow using venous occlusion strain gauge plethysmography.
  • Assessed endothelium-dependent (reactive hyperemia) and independent (nitrate) vasodilation.

Main Results:

  • Significantly higher IL-6 levels in ischemic and dilated cardiomyopathy compared to controls and CAD patients.
  • Significantly higher TNF-alpha levels in both ischemic and dilated cardiomyopathy groups compared to CAD and controls.
  • Lower forearm vasodilatory response (RH%) in both ischemic and dilated cardiomyopathy compared to CAD and controls, with greater impairment in ischemic heart failure.

Conclusions:

  • Both ischemic and dilated cardiomyopathy demonstrate impaired endothelial function and elevated inflammatory markers.
  • Ischemic heart failure exhibits more severe endothelial dysfunction than dilated cardiomyopathy.
  • Underlying atherosclerosis likely contributes to the greater endothelial dysfunction observed in ischemic heart failure.
Abstract

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