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Cytokine activation and disease progression in patients with stable moderate chronic heart failure

H Tanner1, P Mohacsi, G A Fuller-Bicer

  • 1Department of Cardiology, University Hospital, Bern, Switzerland.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|June 5, 2007
PubMed

Insights

C-reactive protein (CRP) and B-type natriuretic peptide (BNP) identify high-risk patients with moderate congestive heart failure (CHF). Elevated CRP and BNP indicate increased mortality, independent of cardiac function, suggesting CRP as a surrogate for interleukin-6 and complement activation.

Area of Science:

  • Cardiology
  • Immunology
  • Biomarker Research

Background:

  • Cytokine and complement system activation are linked to severe congestive heart failure (CHF) progression.
  • The prognostic significance of these activations in moderate CHF remains unclear.

Purpose of the Study:

  • To measure cytokine and complement activation in moderate CHF patients.
  • To evaluate C-reactive protein (CRP) as a surrogate marker for these activations.
  • To determine if CRP provides independent prognostic information alongside B-type natriuretic peptide (BNP).

Main Methods:

  • 118 patients were stratified into three groups based on CRP and BNP levels.
  • Group I: CRP > 5 mg/L, BNP >= 200 pg/mL.
  • Group II: CRP <= 5 mg/L, BNP >= 200 pg/mL.
  • Group III: CRP <= 5 mg/L, BNP < 200 pg/mL.

Main Results:

  • Group I exhibited significantly higher mortality (30%) compared to Groups II (2%) and III (4%).
  • Elevated interleukin-6 and terminal complement complex C5b-9 were found in Group I.
  • These elevations correlated with CRP levels, while sCD14 and TNF-alpha did not differ between groups.

Conclusions:

  • C-reactive protein (CRP) can serve as a surrogate marker for interleukin-6 and complement activation in moderate CHF.
  • The combination of CRP and BNP effectively identifies a high-risk patient group.
  • This combined marker offers prognostic information beyond traditional cardiac function assessments.
Abstract

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