Metabolic disturbances and endothelial function in elderly patients with systolic and diastolic chronic heart failure

Aim. To Study the associations between metabolic disturbances, cytokine levels, brain natriuretic peptide (BNP), and endothelial function markers in elderly patients with various types of chronic heart failure (CHF). Material and methods. The Study included 127 men aged 60-75 years (mean age 67,4+/-0,3 years), divided into two groups. Group I consisted of 77 patients with restrictive diastolic CH F (dCHF). Group II included 50 patients with systolic CHF (sCHF). The control group (CG) consisted of 30 healthy volunteers. The levels of pro- and anti-inflammatory cytokines, N-terminal fragment of pro-brain natriuretic peptide (Nt-proBNP), and NO were measured. Results. Metabolic disturbances of varying severity were observed in all elderly patients with CHF In both dCHF and sCHF, endothelial dysfunction was present, which manifested in high levels of microalbuminuria, C-reactive protein, interleukin I beta, and tumor necrosis factor-alpha (TNF-alpha). Cytokine system activation differed in dCHF and sCHF. Conclusion. High levels of TNF-alpha and Nt-proBNP in elderly patients with both types of CHF pointed to a marked left ventricular dysfunction. In sCHF group, significantly higher levels of TNF-alpha, Nt-proBNP, and uric acid were an evidence of more severe clinical course and adverse prognosis of CHF