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首页> 外文期刊>Cytokine >High tumour necrosis factor-alpha levels are associated with exercise intolerance and neurohormonal activation in chronic heart failure patients.
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High tumour necrosis factor-alpha levels are associated with exercise intolerance and neurohormonal activation in chronic heart failure patients.

机译：在慢性心力衰竭患者中，高的肿瘤坏死因子-α水平与运动耐受性和神经激素激活有关。

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Immune activation plays an important role in the progression of chronic heart failure (CHF). We sought to investigate whether different degrees of tumor necrosis factor-alpha (TNF-alpha) activation are associated with exercise intolerance, neurohormonal activation and alterations in muscle mass and function in patients with CHF without cardiac cachexia. Patients were divided into quartiles according to their TNF levels (first quartile: 0.98-4.90 pg/ml, second quartile: 5.00-6.60 pg/ml; third quartile 6.80-9.00 pg/ml; fourth quartile 9.80-32.00 pg/ml). Patients underwent cardiopulmonary exercise testing, quadriceps muscle strength test, quadriceps fatigue test, and assessment of thigh muscle and fat cross-sectional area (CSA) by computerized tomography scanning. Patients in the highest TNF quartile had the lowest peak oxygen consumption [13.1 (+/-4.1) ml/kg/min vs 18.1 (+/-5.3), 18.8 (+/-4.8) and 18.7 (+/-5.6) ml/kg/min, P<0.01] the greatest relation of ventilation and dioxide production (VE/VCO(2)) slope (P<0.05) and the most elevated catecholamine levels (P<0.05) compared to patients in the first three quartiles. Patients with the lowest TNF levels had preserved thigh muscle size and quadriceps strength. Strength/muscle CSA was similar in the four groups. Muscle strength during fatigue testing was significantly lower in the fourth quartile (P=0.01) compared with the other three groups. In CHF patients only the highest levels of TNF are associated with poor functional status and neurohormonal activation. This group of patients may represent the appropriate target population for TNF antagonism.
机译：免疫激活在慢性心力衰竭（CHF）的进程中起重要作用。我们试图调查在没有心脏恶病质的CHF患者中，不同程度的肿瘤坏死因子-α（TNF-α）活化是否与运动耐受性，神经激素活化以及肌肉质量和功能改变有关。根据患者的TNF水平将其分为四分位数（第一四分位数：0.98-4.90 pg / ml，第二四分位数：5.00-6.60 pg / ml;第三四分位数6.80-9.00 pg / ml;第四四分位数9.80-32.00 pg / ml）。患者接受了心肺运动测试，股四头肌肌力测试，股四头肌疲劳测试，并通过计算机断层扫描技术评估了大腿肌肉和脂肪的横截面积（CSA）。处于最高TNF四分位数的患者具有最低的峰值耗氧量[13.1（+/- 4.1）ml / kg / min与18.1（+/- 5.3），18.8（+/- 4.8）和18.7（+/- 5.6）ml /kg/min，P<0.01]与前三个四分位数的患者相比，通气与二氧化氮生成量的最大关系（VE / VCO（2））斜率（P <0.05）和儿茶酚胺水平最高（P <0.05） 。 TNF水平最低的患者保留了大腿肌肉大小和股四头肌力量。四组的力量/肌肉CSA相似。与其他三组相比，第四四分位数的疲劳测试过程中的肌肉强度显着降低（P = 0.01）。在CHF患者中，只有最高水平的TNF与不良的功能状态和神经激素激活有关。这组患者可能代表TNF拮抗作用的适当靶标人群。

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