Background: 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.
Aim: To assess the association between inflammation and ED in CHF.
Material and methods: 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.
Results: 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.
Conclusions: In CHF patients, the presence of ED was associated with increased levels of inflammatory markers.