C-Reactive Protein in Dilated Cardiomyopathy

Kaneko, Katsumi; Kanda, Tsugiyasu; Yamauchi, Y.; Hasegawa, Akira; Iwasaki, Tsutomu; Arai, M.; Suzuki, Tadashi; Kobayashi, Isao; Nagai, Ryozo

doi:10.1159/000006913

Cited by 87 publications

(60 citation statements)

References 20 publications

(19 reference statements)

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“…Lamblin et al confirmed the prognostic value of hs-CRP for adverse cardiac events only in patients with HF of ischemic etiology [30]. Other authors found a strong correlation between hs-CRP levels and poor prognosis also in non-ischemic dilated cardiomyopathy [31,32].…”

Section: Depression and Inflammationmentioning

confidence: 91%

JAKOŚĆ W MEDYCYNIE Depression in chronic heart failure

Szyguła‐Jurkiewicz¹,

Pudło²,

Samborski³

et al. 2012

kitp

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Chronic heart failure (HF) is one of the most challenging problems in cardiology. Depression often coexists with HF. It can develop at any stage of heart disease: as a response to the diagnosis, disease exacerbation or poor prognosis. There is evidence of common pathophysiological pathways in the two diseases: neurohormonal stimulation, arrhythmias, inflammation and blood hypercoagulability. Although the correlation between depression and poor HF prognosis is well recognised, it is still uncertain whether depression treatment can have a positive effect on HF course. It should be noted that tricyclic antidepressants cause orthostatic hypotension, tachycardia and conduction disorders. Most studies confirm the safety of use of selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine in HF patients. In conclusion, the detection of depressive symptoms and the efficacy of depression therapy in HF patients is unsatisfactory. This is largely due to the diagnostic difficulties arising from similar clinical manifestations and lack of guidelines in patients suffering from both diseases. Key words: depression, chronic heart failure. StreszczeniePrzewlekła niewydolność serca (HF) jest jednym z istotnych problemów współczesnej kardiologii. Schorzeniem, które czę-sto współistnieje z HF, jest depresja. Może ona wystąpić na każdym jej etapie jako odpowiedź na rozpoznanie choroby, zaostrzenie objawów lub informację o złym rokowaniu. Istnieją dowody na istnienie wspólnych dla tych dwóch chorób szlaków patofizjologicznych, takich jak pobudzenie neurohormonalne, zaburzenia rytmu, zapalenie i nadkrzepliwość krwi. Mimo udowodnionego związku depresji z niekorzystnym rokowaniem nie ustalono jednoznacznie, czy jej leczenie może wpływać korzystnie na przebieg HF. Należy pamiętać, że trój-pierścieniowe leki przeciwdepresyjne powodują hipotonię ortostatyczną, tachykardię i zaburzenia przewodzenia bodźców. Większość przeprowadzonych dotychczas badań i obserwacji wykazała bezpieczeństwo stosowania selektywnych inhibitorów wychwytu serotoniny), bupropionu i wenlafaksyny u chorych z HF. W podsumowaniu należy podkreślić, że wykrywalność objawów depresyjnych i skuteczność leczenia depresji w grupie chorych z HF jest niezadowalająca. Wynika to przede wszystkim z trudności diagnostycznych związanych z podobnym obrazem klinicznym tych dwóch schorzeń. Słowa kluczowe: depresja, przewlekła niewydolność serca.

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Section: Depression and Inflammationmentioning

confidence: 91%

JAKOŚĆ W MEDYCYNIE Depression in chronic heart failure

Szyguła‐Jurkiewicz¹,

Pudło²,

Samborski³

et al. 2012

kitp

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“…Heart failure is characterized by activation of pro-inflammatory cytokines TNF-a and IL-6 and elevation of C-reactive protein [5,6]. C-reactive protein is an acute-phase protein which, due to its binding specificity for phosphocholine present in a large variety of molecules, recognizes a range of pathogenic targets including membranes of apoptotic and reactive cells [7].…”

Section: Introductionmentioning

confidence: 99%

“…However, these cytokines are elevated in patients with other cardiomyopathies. As this inflammatory marker is associated with adverse prognosis in patients with idiopathic dilated cardiomyopathy [5,6,11], we investigated whether levels of plasma C-reactive protein and IL-6 at baseline could predict clinical outcome in patients with PPCM. In chronic heart failure, low levels of total cholesterol have been found to be a predictor of impaired survival.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Markers-Serum Level of C-Reactive Protein, Tumor Necrotic Factor-α, and Interleukin-6 as Predictors of Outcome for Peripartum Cardiomyopathy

Sarojini

Shanker

Anitha

2013

J Obstet Gynecol India

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Aim/Objective Peripartum cardiomyopathy (PPCM) is a disorder of unknown etiology in which symptoms of heart failure occur between the last month of pregnancy and 5 months post-partum. These findings prompted us to carry out a more detailed study aimed at correlating plasma levels of C-reactive protein TNF-a and IL-6 as prognostic value for major clinical in-hospital events and 6-month follow-up in patients with PPCM. Materials and Methods After ethical clearance, in the present prospective case-control study, a total of 86 subjects were enrolled [patients (n = 46) and controls (n = 40)]. After checking for the inclusion and exclusion criteria, informed consent was obtained and patients were enrolled. The details of history of pre-eclampsia and mode of delivery were obtained from the patients. The history of onset of symptoms and signs was recorded at the first presentation and at 6 months. Clinical assessment, echocardiography, and blood analysis were done at baseline and after 6 months of standard therapy. All patients received treatment with diuretics and the ACE inhibitor (ramipril), Carvedilol if not contraindicated, and inotropic support inj-Dobutamine. Inflammatory markers (C-reactive protein, TNF-a, and IL-6) were measured at baseline and at 6 months. Data were analyzed using the SAS version 9.1 statistical program. Results The characteristics of the study population at first presentation to the cardiac clinic are similar (compared with controls): 0.91 % of the study patients were diagnosed as PPCM patients for the first time and 49 % patients presented within one month after delivery. C-reactive protein (22 vs 08 mg/dl, p \ 0.05), TNF-a (9.6 vs 3.2 pg/dl, p \ 001), and IL-6 (73.19 ± 34.4 vs 31.52 ± 8.83 pg/dl, p \ 0.005) were significantly abnormal, and these patients showed significantly higher LV dimensions, LV EDD (61.6 ± 7.1 vs 46 ± 9 mm p \ 0.004) LV ESD (53.1 ± 7 vs 32 ± 8, p \ 0.005), and significantly lower echocardiographic left ventricular ejection fraction (LVEF) (25.9 ± 8.2 vs 55 ± 12 p \ 0.001) and correlate well with NYHA FC and death. LVEF improved from 25.9 ± 8.2 to 42.9 ? 13.6 % at 6 months (p \ 0.0001). Patients who completed 6 months of standard care showed a significant reduction of heart rate, LV dimensions, and NYHA FC (p \ 0.001). However, normalization of LVEF ([50 %) was only observed in 11 (35 %) patients. Seven patients died within 6 months of diagnoses and eight patients were lost to follow-up. Conclusions Plasma markers of inflammation were significantly elevated in PPCM patients and correlated with increased LV dimensions and lower EF at presentation. Baseline CRP, IL-6, TNF-a, and higher NYHA FC were the only predictors of mortality. These results contribute to inflammation which may contribute to the pathogenesis of PPCM and its complications and predictors of mortality.

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“…(25) CRP is an acute-phase protein which recognizes a range of pathogenic targets, including membranes of apoptotic and reactive cells. (26) As this infl ammatory marker is associated with adverse prognosis in patients with idiopathic dilated cardiomyopathy , (27,28) we investigated if levels of plasma CRP at baseline could predict outcome in patients with PPCM.…”

Section: Translational Approach From Mouse To (Wo)manmentioning

confidence: 99%

Clinical profi ling of patients with peripartum cardiomyopathy and its value for translational research

Förster

Sliwa

ker-Kleiner

2017

SAHJ

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Postpartum cardiomyopathy (PPCM) is a disease of unknown etiology and exposes women to high risk of mortality after delivery despite optimal medical therapy. Experimental data suggested that enhanced oxidative stress promotes the proteolytical processing of the lactation hormone prolactin into a biologically active derivative, the 16kDa prolactin, which appears to be a major cause for PPCM. We observed increased oxLDL levels in a subset of these PPCM patients, indicative of oxidative stress, enhanced Cathepsin D activity and substantial levels of the cleaved 16kDa form of prolactin. We therefore propose that the excessive generation of 16kDa prolactin mediates PPCM in humans and suggest that inhibition of prolactin release may represent a novel therapeutic strategy for PPCM.

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C-Reactive Protein in Dilated Cardiomyopathy

Cited by 87 publications

References 20 publications

JAKOŚĆ W MEDYCYNIE Depression in chronic heart failure

JAKOŚĆ W MEDYCYNIE Depression in chronic heart failure

Inflammatory Markers-Serum Level of C-Reactive Protein, Tumor Necrotic Factor-α, and Interleukin-6 as Predictors of Outcome for Peripartum Cardiomyopathy

Clinical profi ling of patients with peripartum cardiomyopathy and its value for translational research

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