Proinflammatory cytokine levels in patients with diastolic heart failure

Background: The role of cytokines in the pathogenesis of systolic heart failure (HF) has been well established whereas in diastolic HF it remains uncertain.Aim: To define levels of Tumor Necrosis Factor-a (TNFa) and Interleukin-6 (IL-6) in patients with diastolic HF and to reveal their association with functional class and types of left ventricular (LV) diastolic dysfunction.Methods: We examined 26 patients with diastolic HF. The control group consisted of 10 healthy persons. Commonly used echocardiographic parameters of systolic and diastolic function of the LV, thickness of the interventricular septum (IVS), posterior LV wall thickness (PWLV), end-diastolic size of the LV (EDSLV) and left atrial (LA) volume were assessed. Serum levels of TNFa and IL-6 were measured with highly sensitive enzyme-linked immunosorbent assay.Results: The TNFa and IL-6 levels were significantly higher in the group with diastolic HF than in the control group. TNFa and IL-6 levels in groups with impaired LV relaxation and restriction/pseudonormalisation were significantly higher than in the control group. TNFa level was significantly higher in the restriction/pseudonormalisation group than in the group with impaired relaxation, whereas the IL-6 level was similar. The TNFa level was significantly higher in the group with NYHA class III-IV in comparison to the group with NYHA class II. The IL-6 level in these groups was similar. Of the echocardiographic parameters, only LA volume significantly correlated with the TNF± level. No relationship between the IL-6 level and echocardiographic parameters was found.Conclusions: In diastolic HF, serum levels of TNFa and IL-6 are elevated. The magnitude of TNF± elevation is associated with the severity of HF, assessed by NYHA classification, LV diastolic dysfunction level or LA volume