Inflammatory mediators in chronic heart failure: an overview
Open accessAbstract
hronic heart failure (CHF) represents a major public health burden, and its prognosis is comparable to that of different malignant diseases.Our understanding of CHF has developed from the rather simplistic model of mere pump failure to that of a multisystem disorder which affects not only the cardiovascular system but also the musculoskeletal, renal, neuroendocrine, and immune systems.Thus, the pathophysiology of CHF is exceedingly complex.Therapies to block excessive neuroendocrine activation have become a cornerstone of treatment.CHF progresses because of activation of neurohormones and pro-inflammatory cytokines following an initial cardiac injury or a mutation of the genetic programme.1 Virtually any heart disease can ultimately lead to heart failure, although the initial event leading to the development of this syndrome is in many cases unknown.However, CHF is always the result of some underlying process and the diagnosis cannot stand alone.The activation of the aforementioned systems maintains and worsens CHF.In particular, the activation of the immune system has received considerable interest in the last decade.There are several different components to this system which interact with each other in a complex manner.It is becoming increasingly apparent that inflammatory mediators play a crucial role in the development of CHF, and several strategies to counterbalance different aspects of the inflammatory response are considered.Possible targets involve pro-and anti-inflammatory cytokines and their receptors, endotoxin, adhesion molecules, nitric oxide and nitric oxide synthase, reactive oxygen species, and different types of leucocytes.The purpose of this review is to give a brief overview of the current understanding of the role of inflammation in CHF.Furthermore, we will discuss recent advances in the development of new therapeutic strategies in this field.
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In congestive heart failure, pro-inflammatory cytokines TNF, IL-6, and IL-1 are markedly elevated, and TNF level is a negative prognostic factor.
“in patients with congestive heart failure, the levels of pro-inflammatory cytokines, especially TNF, IL-6, and IL-1, are markedly elevated, and the TNF level is a negative prognostic factor”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [190]
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- Authors
- Anker, S. D., & von Haehling, S.
- Affiliations
- Imperial College London (GB)
- Department of Clinical Cardiology, Imperial College School of Medicine, National Heart & Lung Institute, London, UK
- Corresponding author
- Anker, Stefan D
- ORCID
- Anker, Stefan D
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2004-03-12
- Volume
- 90
- Issue
- 4
- Pages
- 464-470
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- PMC
- PMC1768165
- OpenAlex
- W2104179458
- Cited by
- 627
- References
- 33
- Citations by year
- 2026: 21 · 2025: 14 · 2024: 23 · 2023: 17 · 2022: 27 · 2021: 26 · 2020: 23 · 2019: 36 · 2018: 43 · 2017: 43 · 2016: 34 · 2015: 18 · 2014: 35 · 2013: 30 · 2012: 32
- FWCI
- 16.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Herzstiftung
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Keywords
- chronic heart failure, inflammation, inflammatory mediators, inflammatory cytokines, anti-inflammatory cytokines, neuroendocrine activation, neurohormones, endotoxin, adhesion molecules, nitric oxide, reactive oxygen species, leukocytes, immune system, heart failure pathophysiology, anti-inflammatory therapy
- MeSH terms
- Etanercept, Infliximab, Anti-Inflammatory Agents, Non-Steroidal, Antibodies, Monoclonal, C-Reactive Protein, Heart Failure, Humans, Immunoglobulin G, Leukocytes, Myocarditis, Nitric Oxide, Tumor Necrosis Factor-alpha, Cell Adhesion Molecules, Lymphocyte Subsets, Cytokines, Receptors, Tumor Necrosis Factor, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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