In the present study, we evaluated circulating pro-inflammatory mediators and markers of oxidative stress in patients with decompensated CHF (congestive heart failure) and assessed whether clinical recompensation by short-term inotropic therapy influences these parameters. Patients with worsening CHF (n=29, aged 61.9±2.7 years), NYHA (New York Heart Association) class III–IV, and left ventricular ejection fraction of 23.7±1.8% were studied. Controls comprised age-matched healthy volunteers (n=15; 54.1±3.2 years). Plasma levels of cytokines [IL (interleukin)-6 and IL-18], chemokines [MCP-1 (monocyte chemotactic protein-1)], adhesion molecules [sICAM (soluble intercellular adhesion molecule), sE-selectin (soluble E-selectin)], systemic markers of oxidation [TBARS (thiobarbituric acid-reactive substances), 8-isoprostaglandin F2α and nitrotyrosine] and hs-CRP (high-sensitivity C-reactive protein) were measured by ELISA and colorimetric assays at admission and 30 days following 72-h milrinone (n=15) or dobutamine (n=14) infusion. Plasma IL-6, IL-18, sICAM, E-selectin, hs-CRP and oxidative markers were significantly higher in patients on admission before inotropic treatment compared with controls (P<0.05). Short-term inotropic support improved clinical status as assessed by NYHA classification and by the 6-min walk test and significantly decreased plasma levels of IL-6, IL-18, sICAM, hs-CRP and markers of oxidation (P<0.05) at 30 days. The effects of milrinone and dobutamine were similar. In conclusion, our results demonstrate that patients with decompensated CHF have marked systemic inflammation and increased production of oxygen free radicals. Short-term inotropic support improves functional status and reduces indices of inflammation and oxidative stress in patients with decompensated CHF.
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April 2006
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Research Article|
March 15 2006
Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support
Michel White;
Michel White
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Anique Ducharme;
Anique Ducharme
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Reda Ibrahim;
Reda Ibrahim
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Lucette Whittom;
Lucette Whittom
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Joel Lavoie;
Joel Lavoie
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Marie-Claude Guertin;
Marie-Claude Guertin
†Department of Biostatistics, Montreal Heart Institute, Montreal, Québec, Canada, H1T 1C8
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Normand Racine;
Normand Racine
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Ying He;
Ying He
‡CIHR Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada, H2W 1R7
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Guoying Yao;
Guoying Yao
‡CIHR Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada, H2W 1R7
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Jean L. Rouleau;
Jean L. Rouleau
*Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada, H1T 1C8
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Ernesto L. Schiffrin;
Ernesto L. Schiffrin
‡CIHR Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada, H2W 1R7
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Rhian M. Touyz
‡CIHR Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada, H2W 1R7
Correspondence: Dr Rhian M. Touyz, at the present address, Kidney Research Centre, Ottawa Health Research Institute, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, Canada, K1H 8M5 (email rtouyz@uottawa.ca).
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Clin Sci (Lond) (2006) 110 (4): 483–489.
Article history
Received:
October 19 2005
Revision Received:
December 19 2005
Accepted:
January 10 2006
Accepted Manuscript online:
January 10 2006
Citation
Michel White, Anique Ducharme, Reda Ibrahim, Lucette Whittom, Joel Lavoie, Marie-Claude Guertin, Normand Racine, Ying He, Guoying Yao, Jean L. Rouleau, Ernesto L. Schiffrin, Rhian M. Touyz; Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support. Clin Sci (Lond) 1 April 2006; 110 (4): 483–489. doi: https://doi.org/10.1042/CS20050317
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