Metabolic disturbances and endothelial function in elderly patients with systolic and diastolic chronic heart failure
Abstract
Aim. To study the associations between metabolic disturbances, cytokine levels, brain natriuretic peptide (BNP), and endothelial function markers in elderly patients with various types of chronic heart failure (CHF).
Material and methods. The study included 127 men aged 60-75 years (mean age 67,4±0,3 years), divided into two groups. Group I consisted of 77 patients with restrictive diastolic CHF (dCHF). Group II included 50 patients with systolic CHF (sCHF). The control group (CG) consisted of 30 healthy volunteers. The levels of pro- and anti-inflammatory cytokines, N-terminal fragment of pro-brain natriuretic peptide (Nt-proBNP), and NO were measured.
Results. Metabolic disturbances of varying severity were observed in all elderly patients with CHF. In both dCHF and sCHF, endothelial dysfunction was present, which manifested in high levels of microalbuminuria, C-reactive protein, interleukin ip, and tumor necrosis factor-alpha (TNF-а). Cytokine system activation differed in dCHF and sCHF.
Conclusion. High levels of TNF-alpha and Nt-proBNP in elderly patients with both types of CHF pointed to a marked left ventricular dysfunction. In sCHF group, significantly higher levels of TNF-alpha, Nt-proBNP, and uric acid were an evidence of more severe clinical course and adverse prognosis of CHF.
About the Authors
I. A. Sukmanova
Regional Clinical Hospital
Russian Federation
Russian Federation
Barnaul
D. A. Yakhontov
Novosibirsk State Medical University
Russian Federation
Russian Federation
I. V. Osipova
Altay State Medical University
Russian Federation
Russian Federation
Barnaul
References
1. Алмазов В.А., Благосклонная Я.В., Шляхто Я.В. Метаболический сердечно-сосудистый синдром. Санкт- Петербург, изд-во Санкт-Петербургского гос мед университета 1999.
2. Визир В.А., Березин А.Е. Роль иммунной воспалительной активации в формировании и прогрессировании сердечной недостаточности. Укр мед ж 1999; 6(14): 51-8.
3. Климов А.Н., Никульчева Н.Г. Липиды, липопротеиды и атеросклероз. СПб.: Питер 1995; 298 с.
4. Ланкин В.З, Тихазе А.К., Беленков Ю.Н. Свободнорадикальные процессы при патологии сердечно-сосудистой системы. Кардиология 2000; 40(7): 48-61.
5. Ольбинская Л.И., Игнатенко С.Б. Роль системы цитокинов в патогенезе хронической сердечной недостаточности. Тер архив 2001;12: 82-4.
6. Преображенский Д.В., Батыралиев Т.А., Шарошина И.А. Хроническая сердечная недостаточность лиц пожилого и старческого возраста. Москва 2005; 156 с.
7. Терещенко С.Н., Павликова Е.П. Место мозгового натрийуретического пептида в диагностике сердечной недостаточности. Серд недостат 2003; 2(18), том 4: 103-4.
8. Blum A, Miller H. Role of cytokines in heart failure. Am Heart J 1998; 135: 81-186.
9. Cline C. Heart failure in elderly / Tailoring heart Failure Therapy. Eds.R.Willenhenimer, K.Swedberg. London: Martin Dunitz 2003; 15-30.
10. Kpadia S. Cytokines and heart failure. Cardiol Rev 1999;7: 196¬206.
11. Mc Murray J, Abdulian L, Dargie HJ. Increased concentrations of tumor necrosis factor in «cachectic» patients with severe chronic heart failure. Br Heart J 1991; 66: 356-8.
12. Levine B, Kalman J, Mayer L, et al. Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med 1990; 323: 236-382.
13. Oxenham H, Sharpe N. Cardiovascular aging and heart failure. Eur J Heart Failure 2003; 5: 427-34.
14. Schraufstatter IU, Hyslop PA, Jackson J, Соchrane CC. Oxidant injury of cells. Int J Tissue React 1987; 9: 317-24.
15. Torre-Amione G, Kapadia S, Lee J, et al. Tumor necrosis factor-a and tumor necrosis factor receptors in the failing human heart. Circulation 1996; 93: 704-11.
16. Yamaguchi H, Yoshida K. Elevatione of brain nautriuretic pep¬tide of plasma is a hallmark of diastolic heart failure independent of ventricular hypertrophy. JACC 2004; 43(1): 55.
17. Finbel SM, Oddis CV. Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science 1992; 257: 387-9.
Review
For citations:
Sukmanova I.A., Yakhontov D.A., Osipova I.V. Metabolic disturbances and endothelial function in elderly patients with systolic and diastolic chronic heart failure. Cardiovascular Therapy and Prevention. 2009;8(5):33-37. (In Russ.)
Views:
703
Email this article 
