Pathophysiological correlates of increased serum tumor necrosis factor in patients with congestive heart failure. Relation to nitric oxide-dependent vasodilation in the forearm circulation.
Key result
Serum TNF alpha concentrations in patients with CHF were closely correlated with forearm blood flow responses to acetylcholine (r>=0.81, P<0.01) and nitroglycerin (r>=0.65, P<0.05).
Why the study?
Does increased serum TNF alpha correlate with nitric oxide-dependent vasodilation in the forearm circulation of patients with congestive heart failure?
Population
17 patients with stable NYHA class II and III congestive heart failure and 17 age-matched normal subjects.
Comparison
Brachial artery administration of graded… vs CHF patients without detectable serum TNF alpha…
Design
Cross-sectional
Authors
Discussion
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Implication
TNF-α was associated with forearm vasoreactivity in CHF; leaves open causal role in nitric oxide pathways.
Key Points
- This research investigates how elevated tumor necrosis factor-alpha (TNF alpha) affects nitric oxide-mediated vasodilation in congestive heart failure.
- Measured serum concentrations of TNF alpha and interleukins in 17 CHF patients and 17 normal subjects using enzyme-linked immunosorbent assays.
- Assessed forearm blood flow responses to acetylcholine and nitroglycerin using plethysmography.
- 10 out of 17 CHF patients had elevated TNF alpha, showing higher forearm blood flow in response to acetylcholine and nitroglycerin.
- Significant correlations between TNF alpha levels and blood flow responses were observed (r ≥ 0.81, P < 0.01 for acetylcholine; r ≥ 0.65, P < 0.05 for nitroglycerin).
- IL-2 was detected in 14 of 17 CHF patients but not in normals; IL-1 and IL-6 were undetected in both groups.
Study Design
Type
Observational (n=34)
Structured PICO
Does increased serum TNF alpha correlate with nitric oxide-dependent vasodilation in the forearm circulation of patients with congestive heart failure?
P
Population
17 patients with stable NYHA class II and III congestive heart failure (mean age 58 +/- 11 years, mean LVEF 19.5 +/- 7.3%) and 17 age-matched normal subjects.
I
Intervention
Brachial artery administration of graded concentrations of acetylcholine (10^-6 and 10^-5 mol/L) and nitroglycerin (10^-7 and 10^-6 mol/L) to assess forearm blood flow.
C
Comparator
CHF patients without detectable serum TNF alpha, and age-matched normal subjects.
O
Outcome
Forearm blood flow response to acetylcholine and nitroglycerin, and its correlation with serum TNF alpha concentrations.surrogate
Main Result
Effect estimate: r >= 0.81 and r >= 0.65
p-value: p=<0.01 and <0.05
Increased serum TNF alpha concentrations in CHF patients are closely correlated with enhanced forearm blood flow responses to acetylcholine and nitroglycerin, suggesting involvement of nitric oxide synthase in peripheral vasomotor tone regulation.
Cite This Study
Katz et al. (1994) conducted an observational in Congestive heart failure (n=34). Acetylcholine and nitroglycerin vs. Patients without detectable serum TNF alpha was evaluated on Correlation between serum TNF alpha concentrations and forearm blood flow responses to acetylcholine and nitroglycerin (r >= 0.81 and r >= 0.65, p=<0.01 and <0.05). Serum TNF alpha concentrations in patients with CHF were closely correlated with forearm blood flow responses to acetylcholine (r>=0.81, P<0.01) and nitroglycerin (r>=0.65, P<0.05).