Inflammatory Markers Predict Congestive Heart Failure

HEALTH NEWS

Inflammatory markers are independent predictors of congestive heart failure (CHF) and likely reflect the link between obesity and CHF, a new study suggests.(1) In a new analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), researchers led by Dr Hossein Bahrami (Johns Hopkins, Baltimore, MD) report that serum interleukin-6 (IL-6), C-reactive protein (CRP), and albuminuria all predicted the development of CHF over four years, independent of obesity or other established risk factors.

"Our results suggest that inflammation might be involved, directly or as a marker of other underlying conditions, (emphasis added) in the pathologic pathways that link obesity to left ventricular [LV] dysfunction and ultimately CHF," Bahrami et al write.

The study appears in the May 6, 2008 issue of the Journal of the American College of Cardiology.

Authors of the study calculated the hazard ratios (HRs) linking baseline metabolic syndrome, inflammatory markers, insulin resistance, and albuminuria with incidence CHF in the MESA population, after taking into account standard risk factors, interim myocardial infarction (MI), and left ventricular structure and function. MESA enrolled 6814 participants from multiple ethnic backgrounds; median follow-up for the current analysis was four years.

Baharmi and colleagues report that 79 patients developed CHF during follow-up: while obesity was significantly associated with subsequent CHF, the association lost statistical significance after inflammatory markers were included in the model. Obese patients, however were found to have much higher levels of interleukin 6, CRP, and fibrinogen.

According to Baharmi, the findings suggest a mechanistic link between obesity, inflammation, and CHF.

"The implication may be that greater control of obesity may reduce the risk of heart failure and down the road, maybe targeting inflammatory markers may reduce the risk of heart failure related to obesity."

Inflammation may also help explain the link between the metabolic syndrome and CHF risk: inflammation is a known characteristic of the metabolic syndrome, and metabolic syndrome is associated with a higher risk of developing CHF, the authors note.

Reference 

1. Bahrami H, Bluemke DA, Kronmal R, et al. Novel metabolic risk factors for incident heart failure and their relationship with obesity. The Multi-Ethnic Study of Atherosclerosis Study. J Am Coll Cardiol. 2008;51:1775-1783.

Hawthorn Extract Seen As Treatment Option for Chonic Heart Failure

HEALTH NEWS

 
A new study published in the Cochrane Database of Systematic Reviews states that there is "a significant benefit in symptom control and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure."

In beginning the study, researchers noted: "Hawthorn extract is advocated as an oral treatment option for chronic heart failure. Also, the German Commission E approved the use of extracts of hawthorn leaf with flower in patients suffering from heart failure graded stage II."

Researchers reviewed 14 double-blind, placebo-controlled, randomized clinical trails and concluded that hawthorn berry extract may be used as an oral treatment option for chronic heart failure. In most of the studies, hawthorn was used as an adjunct to conventional treatment. Ten trials including 855 patients with chronic heart failure provided data that were suitable for meta-analysis.

Researchers stated: "For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo. Exercise tolerances were significantly increased by hawthorn extract. The pressure-heart rate product, an index of cardiac oxygen consumption, also showed a beneficial decrease with hawthorn treatment. Symptoms such as shortness of breath and fatigue improved significantly with hawthorn treatment as compared with placebo."

Source: Cochrane Database of Systematic Reviews Issue 1, 2008.