Greig Douglas, Castro Pablo, Gabrielli Luigi, Miranda Rodrigo, Verdejo Hugo, Alcaíno Hernán, Bustos Carlos, Chiong Mario, Godoy Iván, Mellado Rosemarie, García Lorena, Salas Daniela, Vivar Raúl, Vukasovic José Luis, Concepción Roberto, Díaz-Araya Guillermo
Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Marcoleta 367, Santiago, Chile.
Rev Med Chil. 2008 Jun;136(6):687-93. Epub 2008 Aug 26.
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.
To assess the association between inflammation and ED in CHF.
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.
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 levels 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.
In CHF patients, the presence of ED was associated with increased levels of inflammatory markers.
在慢性心力衰竭（CHF）中，内皮功能障碍（ED）是血管张力调节物质失衡的结果。ED与炎症之间的关系尚未得到充分研究。
评估CHF中炎症与ED之间的关联。
连续研究了42例年龄为56±14岁（80%为男性）、功能能力为II - III级（纽约心脏协会）且射血分数（FE）<40%的CHF患者。通过肱动脉压迫后超声测量反应性血管舒张来评估ED，根据是否存在ED对患者进行分类。采用酶联免疫吸附测定法（ELISA）测定高敏C反应蛋白（hsCRP）、肿瘤坏死因子α（TNFα）和白细胞介素-6（IL-6）的循环水平。选取15名年龄相仿的健康受试者作为对照组进行研究。
67%的患者存在ED。与对照组相比，CHF患者的hsCRP（分别为0.58±0.4和4.9±7.1mg/dl，p<0.01）和IL-6（分别为1.38±0.06和3.1±1.7mg/dl，p<0.01）水平更高。与无ED的患者相比，CHF合并ED的患者hsCRP（分别为3.0±0.4和6.0±5.7mg/dl，p<0.01）和TNFα（0.31±0.26和1.0±1.1pg/ml，p = 0.02）水平更高。CHF组之间IL-6水平无差异。
在CHF患者中，ED的存在与炎症标志物水平升高有关。
