Key result
Restrictive filling in NICM is linked to increased cytokines, natriuretic peptides, and decreased exercise capacity.
Why the study?
The effect of concomitant diastolic dysfunction on proinflammatory cytokines, natriuretic peptide levels, and exercise capacity in heart failure was not adequately studied.
Is a restrictive filling pattern associated with increased humoral activation and impaired exercise capacity in patients with non-ischemic dilated cardiomyopathy?
Cross-Sectional (n=81)
Is a restrictive filling pattern associated with increased humoral activation and impaired exercise capacity in patients with non-ischemic dilated cardiomyopathy?
Answers are grounded in this paper and cite their sources.
In patients with non-ischemic dilated cardiomyopathy, a restrictive filling pattern is associated with greater proinflammatory cytokine and natriuretic peptide activation, as well as worse exercise tolerance.
OBJECTIVES: Although heart failure (HF) is characterized by increased proinflammatory cytokines, natriuretic peptide levels and impaired exercise capacity, the effect of concomitant diastolic dysfunction on those parameters has not been adequately studied. METHODS: We analyzed circulating levels of IL-1, IL-6, TNF-alpha and its soluble receptors, sTNFRI and sTNFRII, Nt-ANP and Nt-BNP natriuretic peptides in 81 patients, aged 56+/-12 years, with non-ischemic dilated cardiomyopathy (NIDC), LVEF 29.7+/-7.75% and functional NYHA class II-III. An echocardiographic study and cardiopulmonary exercise test (CPE) were performed in all patients. RESULTS: Patients were divided into restrictive (24 patients, group I) and non-restrictive (57 patients, group II) groups, according to their transmitral-filling pattern. No differences in LV dimensions or LVEF were found between the two groups. Group I showed increased levels of IL-6 (P=0.006), TNF-alpha (P=0.05), sTNFRII (P=0.02), Nt-ANP (P<0.001) and Nt-BNP (P<0.001) and decreased exercise duration (P<0.001) and PVO(2) (P<0.001) compared to group II. The strongest independent predictors for restrictive filling pattern were Nt-ANP and IL-6 levels, while Nt-BNP levels were the strongest PVO(2) predictor. CONCLUSIONS: Restrictive filling pattern implying greater diastolic dysfunction may contribute to increased cytokine production in the heart failure syndrome, as well as greater increases in natriuretic peptides and decreased exercise tolerance.
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Parthenakis et al. (2004) conducted a cross-sectional in Non-ischemic dilated cardiomyopathy (NIDC) (n=81). Restrictive transmitral-filling pattern vs. Non-restrictive filling pattern was evaluated on Cytokine levels, natriuretic peptide levels, and exercise capacity (PVO2 and exercise duration) (p=<0.001). A restrictive filling pattern in non-ischemic dilated cardiomyopathy was associated with increased IL-6, TNF-alpha, and natriuretic peptides, and decreased exercise capacity (P<0.001 for PVO2).
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