Cytokine agression and heart failure

Abstract

Heart failure is a complex neurohumoral and inflammatory syndrome. The role of cytokines in the pathogenesis of cardiovascular disease is increasingly evident since the identification of immune/inflammatory mechanisms in atherosclerosis and heart failure. The aim of the study was to examine the features of changing levels of pro-(IL-1β) and anti-inflammatory (IL-4) cytokines in the serum of patients with the progression of chronic heart failure (CHF). A total amount of 48 patients (30 women and 18 men) aged 45 to 78 years with CHF I-IV functional class (FC) on the classification of NYHA. The control group included 24 healthy people matched for age and sex. It was found that the concentration of IL-1β was increased in patients in FC III compared to the control value (49.2%, p <0.001), and also in relation to I and II FC (31.3% and 23.0%, respectively). The level of cytokines was significantly increased with FC IV, differing from that in the control group (77.1%, p <0.001), I (55.9%), in the II (46.1%) and III (18.7%) FC groups. Patients with I and II FC were not significantly different from the control and each other by IL-1β level. The content of the anti-inflammatory IL-4 was the lowest in the serum of patients with FC IV, significantly differs from that in the control group (19.5%, p <0.05) in II FC(16.2%) and III FC(13 , 6%) groups, but did not differ significantly from that of the I FC. Patients of the I, II and III FC in terms of IL-4 did not differ among themselves and from the reference values. The IL-1β / IL-4 ratio which characterizes the balance of pro-and antiinflammatory cytokines were significantly higher than the control in all groups of CHF. The value of this index was lowest in patients of I and II FC. With the progression of CHF value of the index was significantly increased comparing to the control group, the patients I - III FC class respectively. These data may indicate a shift of the pro-inflammatory cytokine network capacity already at the lowest expressed signs of heart failure (I FC), with a further increase as the worsening of the disease.