The clinical relevance of circulating tumor necrosis factor-alpha in acute decompensated chronic heart failure without cachexia
The clinical relevance of circulating tumor necrosis factor-alpha in acute decompensated chronic heart failure without cachexia
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DOI：
10.1378/chest.110.4.992
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发表时间：
1996-10-01
期刊：
影响因子：
9.6
通讯作者：
Ventura, HO
中科院分区：
文献类型：
--
作者：
Milani, RV;Mehra, MR;Ventura, HO
Study objective: To evaluate the clinical relevance of circulating tumor necrosis factor-alpha (TNF alpha) in subjects with advanced acutely decompensated congestive heart failure (CHF) and to determine the modulatory effect of clinical interventions on short-term elaboration of this cytokine.Design: Prospective, case-controlled study.Setting: Inpatient and outpatient (hospital and clinic), at regional academic medical center.Patient interventions: Plasma concentrations of TNF alpha were determined in 25 healthy, normal control subjects and in 29 noncachectic patients with advanced CHF (mean ejection fraction=16+/-6%) who required hospitalization for IV diuretic and/or inotropic therapy despite optimization of oral medical regimens. CNF patients were divided into two groups: diuretic responsive (group A; n=6) and diuretic resistant requiring inotropic support (group B; n=23), Group B was randomly allocated to receive either IV dobutamine (n=13) or milrinone (n=10) for 72 h, TNF alpha levels in CHF patients were measured serially at baseline, at 6 h, at 48 h, at 72 h, and at 1-week follow-up after hospital discharge.Results: Plasma TNF alpha levels at baseline in CHF patients were 4.0+/-1.1 pg/mL, (range, 0.5 to 6.5 pg/mL) and 2.5+/-0.6 pg/mL (range, 0.5 to 6.8 pg/mL) in groups A and B, respectively, which were significantly different ((p
