ISSN: 0970-938X (Print) | 0976-1683 (Electronic)

Biomedical Research

An International Journal of Medical Sciences

Abstract

A study of inflammatory markers and their correlation with severity, in patients with chronic heart failure

Immune system activation in CHF has received considerable interest in the last decade. It is now becoming apparent that inflammatory mediators play a crucial role in the development of CHF. Therefore, the present study was undertaken with the aim to evaluate the association between inflammatory markers and CHF and to correlate them with severity of CHF. A total of 42 subjects were initially classified into 2 groups. First group was control group. Second group was CHF group, which on the basis of their current NYHA status was further subdivided into 2 groups, as either having Mild CHF (including patients in NYHA class I or II, n=13) or Severe CHF (including patients in NYHA class III or IV, n=19). Assessment of physical parameters included heart rate and BMI. Plasma levels of hs-CRP and TNF-α were estimated. Routine blood investigations included hemoglobin, plasma glucose, blood urea, serum creatinine, serum lipids, serum sodium and potassium. Echocardiography was done on every patient. BMI in severe CHF group was significantly lower when compared with control (p<0.01) and mild CHF group (p<0.05). Heart rate was also significantly raised in CHF group. LVEF and LVFS was significantly lower in patients with mild CHF (p<0.01 for both) and severe CHF (p<0.01for both) when compared with control. Mean hemoglobin was significantly lower in patients of mild CHF (p<0.05) and severe CHF (p<0.05) when compared with controls. Circulating level of hs-CRP and TNF-α was significantly elevated in CHF patients (p<0.01), and increased with severity of CHF (p<0.01). There was a strong correlation of NYHA functional class with hs-CRP (r=0.527, p<0.01) and TNF-α (r=0.89, p<0.01). hs-CRP and TNF-α levels are significantly elevated in patients with CHF. There is a strong association between hs-CRP & TNF-α levels and severity of chronic heart failure. BMI is a significant associated with levels of hs-CRP and TNF-α. No correlation was found between LVEF and levels of hs-CRP and TNF-α. TNF-α and hs-CRP levels are elevated irrespective of the presence or absence of coronary artery disease suggesting, CHF as a final common pathway for a variety of cardiac disorders.

Author(s): Nooralam Ansari, Asif Hasan, Mohammad Owais
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