Correlation between sTNFR-I and other negative prognostic factors in patients with chronic heart failure

Tumor necrosis factor (TNF-alpha) and plasma levels of soluble tumor necrosis factor receptor I (sTNFR-I) are increased in patients with heart failure as an expression of chronic inflammation, representing a negative prognostic factor. Anemia and low serum lipid fraction are also negative prognostic factors, whose relationship with sTNFR-I has been less studied.

The study investigated 54 patients with heart failure, 40 ischemic and 14 nonischemic, 35 males and 19 females, aged 65 +/- 10 years. Plasma sTNFR-I values (nv < 3 pg/ml) and serum lipid fractions were determined in each patient and the prevalence of anemia (Ht < or = 41% in men; Ht < or = 38% in women) was established. Left ventricular ejection fraction (LVEF) was determined by using 2D echo.

sTNFR-I was increased in patients with heart failure--222.79 +/- 97.08 pg/ml. Anemia was found in 40.74% of the patients, sTNFR-I being significantly increased in patients with anemia (242.82 +/- 49.12 pg/ml) compared to patients without anemia (194.9 +/- 117.3); p < 0.05. TChol (152.63 +/- 55.4 vs 177.81 +/- 38.52 mg%), LDLChol (101.47 +/- 42.4 vs 113.59 +/- 28.3 mg%) and TG (96.22 +/- 59.12 vs 132.09 +/- 96.55 mg%) were insignificantly lower in patients with anemia. Patients with anemia and low LVEF did not present higher sTNFR-I values (236.548 +/- 47.2) compared to patients with LVEF > 40% (245.75 +/- 52.1). A weak negative correlation r = -0.31 was noted between sTNFR-I and Ht in anemic patients and also between sTNFR-I and TChol (r = -0.31), LDLchol (r = -0.28), TG(r = -0.22). No correlation could be established between TChol, LDLchol, TG and Ht.

In patients with heart failure, increased sTNFR-I as an expression of chronic inflammation is correlated with both anemia and low serum lipid fractions even if the exact nature of the relationship has yet to be established. There is no direct correlation between anemia and low serum lipid fractions.