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March 16, 2012PLoS ONEOpen Access

Enhanced Interleukin-1 Activity Contributes to Exercise Intolerance in Patients with Systolic Heart Failure

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Why the study?

Does anakinra improve cardiopulmonary exercise performance in patients with systolic heart failure and elevated inflammatory signaling?

Population

7 patients with systolic heart failure and evidence of elevated inflammatory signaling, and a preclinical…

Comparison

Anakinra (IL-1 receptor antagonist) vs Baseline (pre-treatment)

Design

Cohort

Key result

Anakinra treatment for 14 days significantly improved median peak oxygen consumption from 12.3 to 15.1 mL/kg/min in patients with systolic heart failure and elevated inflammatory signaling.

Authors

BTBenjamín W. Van TassellRARoss ArenaSTStefano Toldo

Discussion

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Member takes

Overview

Hypothesis-generating for anakinra in inflammatory systolic HF; larger RCTs needed before practice change.

Structured PICO

Does anakinra improve cardiopulmonary exercise performance in patients with systolic heart failure and elevated inflammatory signaling?

P
Population
7 patients with systolic heart failure and evidence of elevated inflammatory signaling, and a preclinical model of healthy mice injected with IL-1β or plasma from HF patients
I
Intervention
Anakinra (IL-1 receptor antagonist)
C
Comparator
Baseline (pre-treatment)
O
Outcome
Cardiopulmonary exercise performance (peak oxygen consumption [VO2] and ventilator efficiency [VE/VCO2 slope])surrogate

Main Result

Absolute Event Rate: 15.1% vs 12.3%

p-value: p=0.016

Limitations

  • Inability to elucidate the exact signaling mechanism of IL-1-induced systolic dysfunction
  • IL-1β is not the only circulating factor in human plasma with the potential to alter cardiac function
  • Lack of randomization limits the interpretation of study results to imply a definitive cause-and-effect relationship
  • Small sample size inherent to a pilot study design

Cite This Study

Tassell et al. (2012) studied Systolic Heart Failure (n=7). Anakinra vs. Baseline was evaluated on Peak oxygen consumption (VO2) (p=0.016). Anakinra treatment for 14 days significantly improved median peak oxygen consumption from 12.3 to 15.1 mL/kg/min in patients with systolic heart failure and elevated inflammatory signaling.

synapsesocial.com/papers/6a0663f0cc83fae8617783a4https://doi.org/10.1371/journal.pone.0033438
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