Cited by 810Heart Failure Treatment and ManagementCardiac Fibrosis and RemodelingInflammatory Biomarkers in Disease Prognosis

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Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure

Rauchhaus, Mathias, Doehner, Wolfram, Francis, Darrel P., Davos, Constantinos, Kemp, Michael, Liebenthal, Christa, Niebauer, Josef, Hooper, James, Volk, Hans-Dieter, Coats, Andrew J. S., Anker, Stefan D.·2000·Circulation

DOI 10.1161/01.cir.102.25.3060

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Abstract

Background —Inflammatory immune activation is an important feature in chronic heart failure (CHF). Little is known about the prognostic importance of tumor necrosis factor-α (TNF-α), soluble TNF-receptor 1 and 2 (sTNF-R1/sTNF-R2), interleukin-6 (IL-6), and soluble CD14 receptors (sCD14) in CHF patients. Methods and Results —In 152 CHF patients (age 61±1 years, New York Heart Association [NYHA] class 2.6±0.1, peak V̇ o 2 17.3±0.6 mL · kg −1 · min −1 , mean±SEM) plasma concentrations of immune variables were prospectively assessed. During a mean follow-up of 34 months (>12 months in all patients), 62 patients (41%) died. Cumulative mortality was 28% at 24 months. In univariate analyses, increased total and trimeric TNF-α, sTNF-R1, and sTNF-R2 (all P ≤0.0001), sCD14 ( P =0.0007), and IL-6 ( P =0.005) predicted 24-month mortality. With multivariate analysis and receiver operating characteristics, sTNF-R1 emerged among all cytokine parameters as the strongest and most accurate prognosticator in this CHF population, regardless of follow-up duration and independently of NYHA class, peak V̇ o 2 , V̇ e /V̇ co 2 slope, left ventricular ejection fraction, and wasting ( P <0.001). The receiver operating characteristic area under the curve for sTNF-R1 was greater than for sTNF-R2 at 6, 12, and 18 months (all P <0.05). Conclusions —sTNF-R1 was the strongest and most accurate prognosticator, independent of established markers of CHF severity. Assessment of sTNF-R1 may be useful in identifying patients who are at high risk of death and in monitoring patients undergoing anti–TNF-α treatment.

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Authors: Rauchhaus, M., Doehner, W., Francis, D. P., Davos, C., Kemp, M., Liebenthal, C., Niebauer, J., Hooper, J., Volk, H.-D., Coats, A. J. S., & Anker, S. D.
Affiliations: Royal Brompton Hospital (GB)
From Clinical Cardiology, National Heart and Lung Institute (M.R., W.D., D.P.F., C.D., J.N., A.J.S.C., S.D.A.), and Biochemistry, Royal Brompton Hospital (M.K., J.H.), London, UK; the Universitätsklinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität (M.R.), Halle, Germany; and the Institut für Medizinische Immunologie, Charité (Campus Mitte) (C.L., H.-D.V.), and Franz-Volhard-Klinik (Charité, Campus Berlin-Buch) am Max-Delbrück Centrum für Molekulare Medizin (S.D.A.),...
ORCID: Doehner, Wolfram
Davos, Constantinos
Niebauer, Josef
Hooper, James
Volk, Hans-Dieter
Coats, Andrew J. S.
Anker, Stefan D.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2000-12-19
Volume: 102
Issue: 25
Pages: 3060-3067
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.102.25.3060
OpenAlex: W2066885413
Cited by: 810
References: 27
Citations by year: 2026: 15 · 2025: 19 · 2024: 25 · 2023: 20 · 2022: 31 · 2021: 24 · 2020: 31 · 2019: 22 · 2018: 26 · 2017: 24 · 2016: 24 · 2015: 24 · 2014: 35 · 2013: 35 · 2012: 35
FWCI: 21.26
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
Keywords: chronic heart failure, plasma cytokines, soluble TNF receptor 1, soluble TNF receptor 2, TNF-α, interleukin-6, soluble CD14, inflammation, mortality prediction, prognostic factors, anti-TNF therapy
MeSH terms: Adult, Aged, Aged, 80 and over, Analysis of Variance, Cardiac Output, Low, Chronic Disease, Female, Humans, Immunoassay, Male, Middle Aged, Prognosis, ROC Curve, Solubility, Tumor Necrosis Factor-alpha, Biomarkers, Antigens, CD, Interleukin-6, Survival Analysis, Cytokines, Receptors, Tumor Necrosis Factor, Lipopolysaccharide Receptors, Receptors, Tumor Necrosis Factor, Type I, Receptors, Tumor Necrosis Factor, Type II

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Plasma Cytokine Parameters and Mortality in Patients With Chronic Heart Failure

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