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Interleukin-6 in Patients With Heart Failure and Preserved Ejection Fraction.
Alessio Alogna1, Katlyn E Koepp2, Michael Sabbah2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany.
JACC. Heart Failure
|August 11, 2023
Summary
Interleukin-6 (IL-6) is elevated in heart failure with preserved ejection fraction (HFpEF) and linked to worse exercise capacity and symptoms. Inhibiting IL-6 may improve HFpEF patient status.
Area of Science:
- Cardiology
- Immunology
- Internal Medicine
Background:
- Interleukin-6 (IL-6) is a key inflammatory mediator implicated in heart failure (HF).
- Elevated IL-6 levels are documented in HF, but data specific to heart failure with preserved ejection fraction (HFpEF) are limited.
Purpose of the Study:
- To investigate the relationship between IL-6 levels and cardiac function, congestion, body composition, and exercise tolerance in patients with HFpEF.
- To understand the clinical implications of IL-6 in the HFpEF population.
Main Methods:
- Analysis of clinical, laboratory, body composition, and exercise capacity data from 374 HFpEF patients across four NHLBI-sponsored trials.
- Patients were stratified into tertiles based on measured IL-6 concentrations.
Main Results:
- Higher IL-6 levels correlated with increased body mass index, elevated inflammatory markers (NT-proBNP, CRP, TNF-α), poorer renal function, and lower hemoglobin.
- Despite similar resting cardiac structure and function, patients with the highest IL-6 exhibited significantly reduced peak oxygen consumption and 6-minute walk distance.
- IL-6 was associated with greater body fat, particularly trunk fat, increased symptoms during submaximal exercise, and diminished patient-reported health status.
Conclusions:
- Elevated IL-6 is common in HFpEF and associated with greater symptom burden, reduced exercise capacity, and increased adiposity.
- These findings suggest that IL-6 inhibition could be a potential therapeutic strategy to improve clinical outcomes in HFpEF.
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