Complement activation, endothelial dysfunction, insulin resistance and chronic heart failure

Abstract

Independent associations between sMAC, sEsel and IR were found in the CHF patients and we hypothesize that IR leading to endothelial activation results in activation of the complement system and thus damaging of the heart tissue.

Complement Activation and Prognosis in Patients With Type 2 Diabetes and Myocardial Infarction

“…The plasma levels of sC5b-9 in the present cohort are higher (median 134 μg/L at admission) than those reported in a study comprising 193 patients with congestive heart failure (sC5b-9: 88 [69–128] μg/L) and healthy age-matched control subjects (sC5b-9: 98 [72–170] μg/L) (21). The high admission levels may, at least in part, be a result of the activation of the complement cascade due to acute ischemia.…”

“…2. In fact, in the above-mentioned heart failure study, sC5b-9 levels were elevated in patients with congestive heart failure due to ischemic heart disease in contrast to patients with congestive heart failure of nonischemic etiology ( P < 0.02) (21). Despite differing in absolute quantity (no international standard is available for standardization), the present findings fit with the report by Yasuda et al (20) of significantly higher plasma sC5b-9 levels in patients with AMI (810 ± 80 μg/L [mean ± SEM]) than with unstable angina (150 ± 50 μg/L), stable angina (90 ± 60 μg/L), or healthy control subjects (60 ± 30 μg/L).…”

Inflammatory Biomarkers in Ischemic Heart Disease

“…The predictive value of low peripheral plasma sC5b-9 may be explained by an accumulation and activation of sC5b-9 in the infarcted myocardium. Furthermore, an elevated plasma sC5b-9 level was found in patients with chronic heart failure due to IHD (Bjerre et al, 2010). In addition, an independent association between sC5b-9, insulin resistance and endothelial dysfunction was found, which may suggest that insulin resistance leading to endothelial activation results in activation of the complement system thus damaging the heart.…”

“…Diabetes and CVD often appear as two sides of a coin: on one side, diabetes has been rated as an equivalent of CVD, and conversely, many patients with established CVD suffer from overt or incipient diabetes (Ryden et al, 2007). The mortality from AMI is almost increased fivefold in diabetic patients compared with non-diabetics (Hansen et al, 2007) and diabetes and low-grade inflammation is closely related (Flyvbjerg, 2010). Obesity is seen at epidemic proportions all over the world, and is a significant risk factor for, and contributing factor to increased morbidity and mortality, most importantly from CVD and diabetes (Lavie et al, 2009a).…”

Heart failure is associated with reduced patency after endovascular intervention for symptomatic peripheral arterial disease

“…24 In addition, CHF is a disease not limited to the heart, and peripheral vascular dysfunction at the cellular level is a topic of ongoing investigation. [25][26][27] Specifically, several recent reports have identified impaired nitric oxide metabolism in patients with CHF. [27][28][29][30] …”