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Titolo:
Effect of high- versus low-dose angiotensin converting enzyme inhibition on cytokine levels in chronic heart failure
Autore:
Gullestad, L; Aukrust, P; Ueland, T; Espevik, T; Yee, G; Vagelos, R; Froland, SS; Fowler, M;
Indirizzi:
Univ Hosp Oslo, Rikshosp, Sect Clin Immunol & Infect Dis, Oslo, Norway Univ Hosp Oslo Oslo Norway Sect Clin Immunol & Infect Dis, Oslo, Norway Univ Hosp Oslo, Rikshosp, Internal Med Res Inst, Dept Med A, Oslo, Norway Univ Hosp Oslo Oslo Norway ernal Med Res Inst, Dept Med A, Oslo, Norway Norwegian Univ Sci & Technol, Inst Canc Res & Mol Biol, Trondheim, Norway Norwegian Univ Sci & Technol Trondheim Norway l Biol, Trondheim, Norway Stanford Univ, Falk Cardiovasc Res Ctr, Sch Med, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 Ctr, Sch Med, Stanford, CA 94305 USA Univ Hosp Oslo, Rikshosp, Dept Cardiol, Oslo, Norway Univ Hosp Oslo OsloNorway p Oslo, Rikshosp, Dept Cardiol, Oslo, Norway Univ Hosp Oslo, Rikshosp, Dept Med B, N-0027 Oslo, Norway Univ Hosp Oslo Oslo Norway N-0027 shosp, Dept Med B, N-0027 Oslo, Norway
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 34, anno: 1999,
pagine: 2061 - 2067
SICI:
0735-1097(199912)34:7<2061:EOHVLA>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
NECROSIS-FACTOR-ALPHA; CIRCULATING ADHESION MOLECULES; CARDIAC MYOCYTES; MYOCARDIAL-INFARCTION; NITRIC-OXIDE; ACTIVATION; ENALAPRIL; SURVIVAL; GP130; HYPERTENSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Gullestad, L Univ Hosp Oslo, Rikshosp, Dept Med B, N-0027 Oslo, Norway Univ Hosp Oslo Oslo Norway N-0027 ed B, N-0027 Oslo, Norway
Citazione:
L. Gullestad et al., "Effect of high- versus low-dose angiotensin converting enzyme inhibition on cytokine levels in chronic heart failure", J AM COL C, 34(7), 1999, pp. 2061-2067

Abstract

OBJECTIVES We examined the effect of long term treatment with two doses ofthe angiotensin converting enzyme (ACE) inhibitor enalapril on various immunological variables in patients with chronic congestive heart failure (CHF). BACKGROUND Immunological mediators are increasingly recognized to play a pathogenic role in the pathophysiology of CHF. Whether ACE inhibitor therapymodifies immunological variables has not previously been investigated. METHODS Seventy-five patients (mean age 52 +/- 11 pears) with CHF were randomized between low(5 mg daily) and high-dose (40 mg daily) enalapril in a double-blind trial. Circulating levels of immunological parameters (i.e., proinflammatory cytokines, chemokines and adhesion molecules) were measured at baseline, at 10 weeks and at the end of the study (34 weeks). RESULTS All immunological parameters, except soluble interleukin (IL)-6 receptor, were increased in CHF compared with 21 healthy controls. During thestudy immunoreactive IL-6 levels decreased (p < 0.05) and soluble IL-6 receptor increased (p < 0.05) during high-dose but not during low-dose enalapril therapy. Furthermore, IL-6 bioactivity decreased only during the high-dose (p < 0.001), resulting in a significant difference in change during treatment between the two dosage groups (p < 0.001). This decrease in IL-6 bioactivity was significantly associated with decreased interventricular septumthickness as assessed by echocardiography (r = 0.56, p = 0.013). No other variables changed during treatment. CONCLUSIONS In patients with severe CHF, high-dose enalapril therapy is associated with a significant decrease in IL-6 activity. However, despite treatment with a high-dose ACE inhibitor, a persistent immune activation exists in these patients which may be of importance for the progression of CHF. (C) 1999 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:42:47