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Cardiac function, inflammatory mediators and mortality in critical limb ischemia

Jamal Barani1, Ingrid Mattiasson, Bengt Lindblad

  • 1University of Lund, Department of Vascular Diseases, Malmö University Hospital, Malmö, Sweden. jamal.barani@skane.se

Angiology
|October 7, 2006
PubMed

Insights

Patients with critical limb ischemia (CLI) experience higher cardiac risks. This study found that cardiac rhythm disturbances and ECG changes in CLI patients are linked to inflammation and predict one-year mortality.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Inflammation Research

Background:

  • Critical limb ischemia (CLI) often coexists with coronary heart disease and congestive heart failure.
  • Understanding the interplay between cardiac function, inflammation, and outcomes in CLI is crucial.

Purpose of the Study:

  • To evaluate cardiac function in relation to inflammatory markers and one-year mortality in patients with CLI.
  • To investigate the association between specific cardiac abnormalities and inflammatory mediators.

Main Methods:

  • Prospective study of 232 CLI patients.
  • Electrocardiogram (ECG), plasma inflammatory markers (ET-1, TNFα, IL-6, neopterin, CD40 ligand, 8-epi-PGF2α), and echocardiography (in 88 patients).
  • One-year mortality assessment.

Main Results:

  • Ischemic ECG changes were associated with higher endothelin-1, 8-epi-PGF2α, neopterin levels, and increased one-year mortality.
  • Atrial fibrillation/flutter correlated with higher IL-6 and neopterin.
  • Echocardiographic findings of heart failure correlated with inflammatory markers (IL-6, TNFα, neopterin).
  • Lower ejection fraction (<40%) predicted higher one-year mortality.

Conclusions:

  • Cardiac rhythm disturbances and ischemic ECG changes in CLI patients are linked to inflammatory mediators.
  • These cardiac abnormalities and inflammatory markers predict one-year mortality in CLI.
  • Inflammatory markers correlate with echocardiographic evidence of heart failure in CLI patients.

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