Time-course of changes in the levels of interleukin 6 in acutely decompensated heart failure

Background Although cytokine elevation has been demonstrated in chronic heart failure, little attention has been focused on cytokine levels during the acute stage. We examined the changes of cytokine levels in patients with acutely decompensated heart failure to investigate their relationship with severity of heart failure. Methods Patients with acutely decompensated heart failure (73 patients; 72±2 years) were included. Blood samples were taken from the peripheral vein on admission before the start of drug therapy, at 12, 24, 48 and 72 h as well as 1, 2 and 4 weeks after admission. Control data were obtained from age-matched normal patients who had no cardiovascular disease. Serum IL-6, IL-1β and TNF-α levels were measured using the ELISA method. Results Mean IL-6, IL-1β and TNF-α levels on admission were significantly higher than those in the control patients (p<0.001). IL-6 peaked at 12 h and declined thereafter, whereas IL-1β and TNF-α remained unchanged throughout the duration of the study. Peak IL-6 significantly correlated with pulmonary wedge pressure on admission (r=0.332, p=0.0041). % change of IL-6 levels between peak (12 h after admission) and 24 h was significantly correlated with that of pulmonary wedge pressure between peak (on admission) and 24 h (r=0.308, p=0.0081). Peak IL-6 in patients treated with mechanical ventilation on admission was significantly higher than that in patients who underwent no mechanical ventilation (p<0.05). Conclusions IL-6 levels possibly reflect the severity of heart failure and thus may be useful for the evaluation of disease status in acutely decompensated heart failure.