Inflamación y disfunción endotelial en pacientes con insuficiencia cardiaca crónica

Douglas Greig ^[1] ; Pablo Castro ^[1] ; Luigi Gabrielli ^[1] ; Rodrigo Miranda ^[1] ; Hugo Verdejo ^[1] ; Hernán Alcaíno ^[2] ; Carlos Bustos ^[2] ; Mario Chiong ^[2] ; Iván Godoy ^[1] ; Rosemarie Mellado ^[2] ; Lorena García ^[2] ; Daniela Salas ^[2] ; Raúl Vivar ^[2] ; José Luis Vukasovic ^[2] ; Roberto Concepción ^[3] ; Guillermo Díaz-Araya ^[2]
1. [1] Pontificia Universidad Católica de Chile
  
  Pontificia Universidad Católica de Chile
  
  Santiago, Chile
2. [2] Universidad de Chile
  
  Universidad de Chile
  
  Santiago, Chile
3. [3] Hospital Dipreca
  
  Hospital Dipreca
  
  Santiago, Chile
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Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 136, Nº. 6, 2008, págs. 687-693
Idioma: español
Títulos paralelos:
- Inflammation and endothelial dysfunction in patients with chronic heart failure
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Resumen
- Background: In chronic heart failure (CHF), endothelial dysfunction (ED) is a consequence of an imbalance of vascular tone regulating substances. The relationship between ED and inflammation has not been fully investigated. Aim: To assess the association between inflammation and ED in CHF. Material and methods: Forty two patients aged 56±14 years (80% male) with a CHF in functional capacity II-III (New York Heart Association) and an ejection fraction (FE) <40% were consecutively studied. Patients were classified according to the presence or absence of ED, evaluated by reactive vasodilation measured by ultrasound, after brachial artery compression. Circulating levels of highly sensitive C reactive protein (usCRP), tumor necrosis factor a (TNFá) and interleukin-6 (IL-6) were determined by ELISA. A group of 15 healthy subjects of similar age, were studied as controls. Results: Sixty seven percent of patients had ED. Compared to controls, patients with CHF had higher usCRP (0.58±0.4 and 4.9±7.1 mg/dl respectively, p <0.01) and IL-6 (1.38±0.06 and 3.1±1.7 mg/dl respectively, p <0.01). Compared to patients without ED, patients with CHF and ED had higher levéis of usCRP (3.0±0.4 and 6.0±5.7 mg/dl respectively, p <0.01) and TNFá (0.31±0.26 and 1.0±1.1 pg/ml, p =0.02). No differences in IL-6 were found between CHF groups. Conclusions: In CHF patients, the presence of ED was associated with increased levéis of inflammatory markers