TRENDS IN SYSTEMIC INFLAMMATORY FACTORS AND AMINOTERMINAL BRAIN NATRIURETIC PROPEPTIDE IN THE TREATMENT OF CHRONIC HEART FAILURE

Aim. To study trends in systemic inflammatory factors and amino terminal brain natriuretic propeptide (NT-proBNP) in the blood of patients with stage HA and JIB chronic heart failure (CHF) during therapy aimed at reducing venous congestion. Material and methods. The study enrolled 52 patients with postinfarction cardiosclerosis (PICS). Clinical, echocardiographic and laboratory studies were conducted. The levels of TNF-alpha, IL-6, IL-10 and C-reactive protein (CRP) were measured by enzyme immunoassay. The concentration of endotoxin (ET) was estimated by the end-point chromogenic LAL test, that of NT-proBNP - by immunochromotographic assay. Results. In the patients with CHF, clinical signs of pulmonary venous congestion are associated with a statistically significant increase in the blood levels of TNF-alpha and CRP, those of systemic venous congestion are related to a further rise in TNF-alpha levels and elevation of blood concentrations of NT-proBNP, ET and IL-10. Treatment-related reduction in pulmonary venous congection is associated with a decrease in the levels of TNF-alpha, CRP and IL-6; that in systemic venous congestion with lower concentrations of NT-proBNP, TNF-alpha and ET Conclusion. Specific changes in the levels of systemic inflammatory factors and NT-proBNP were found in patients with CHF in the presence of pulmonary and systemic venous congestion. Treatment aimed at elimination of the latter leads to reduction in the levels of systemic inflammatory factors and NT-proBNP.