Beta-Blockade Does Not Alter Plasma Cytokine Concentrations and Ventricular Function in Young Adults With Right Ventricular Dysfunction Secondary to Operated Congenital Heart Disease

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概要

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• Background Right heart failure is a major problem of young adults with congenital heart disease (ACHD) that has been corrected by cardiac surgery. In left ventricular dysfunction (LVD), β-blocker therapy improved cytokine concentrations and clinical status. Thus, the effect of bisoprolol on clinical status and plasma cytokine concentrations in ACHD patients with right heart failure after surgical correction for Tetralogy of Fallot was investigated. Methods and Results A prospective, randomized, double-blind, placebo controlled study for a duration of 6 months was carried out. A total of 34 patients (30.9±9.5 years; New York Heart Association I or II) with brain natriuretic peptide plasma concentrations >100pg/ml and peak oxygen uptake <25ml・kg^<-1>・min^<-1> were recruited. Bisoprolol did not reduce plasma 'concentrations of soluble tumor necrosis factor receptors (sTNF-R) and inter-leukin-6 (IL-6) in ACHD patients (before/after: sTNF-Rl: 750±131/802±130; sTNF-R2: 3,693±1,043/4,166±840; IL-6: 12.94±26.03/13.69±16.58pg/ml). Likewise, peak oxygen uptake, right and left ventricular parameters (determined by magnetic resonance imaging) were not improved by bisoprolol treatment. Conclusion In contrast to previously observed beneficial effect(s) of β-blockade in patients with LVD, there were no beneficial therapeutic effects or cytokine reduction in asymptomatic or minimal symptomatic ACHD patients. These data point to a different pathophysiological role of cytokines in ACHD patients with right ventricular dysfunction, as compared to patients with LVD.

• 社団法人日本循環器学会の論文
• 2008-04-20

著者

• Beibei Li

  Universitatsklinik Und Poliklinik Fur Innere Medizin M Martin-luther-universitdt Halle-wittenberg

• Raab Bjorn

  Department Of Radiology Georg-august-university

• Werdan Karl

  Universitatsklinik Und Poliklinik Fur Innere Medizin M Martin-luther-universitdt Halle-wittenberg

• Norozi Kambiz

  The first two authors contributed equally to the publication

• Buchhorn Reiner

  Department of Paediatrics, Cantos Krankenhaus Bad Mergentheim

• Wessel Armin

  Medical Sociology Unit, Medical School Hannover

• Bahlmann Jens

  Department of Paediatric Cardiology and Intensive Care

• Geyer Siegfried

  Department of Paediatrics, Cantos Krankenhaus Bad Mergentheim

• Kuehne Titus

  Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Institute

• Loppnow Harald

  Universitatsklinik und Poliklinik fur Innere Medizin m, Martin-Luther-Universitdt Halle-Wittenberg

• Loppnow Harald

  Universitatsklinik Und Poliklinik Fur Innere Medizin M Martin-luther-universitdt Halle-wittenberg

• Kuehne Titus

  Department Of Congenital Heart Disease And Paediatric Cardiology German Heart Institute

• Geyer Siegfried

  Department Of Paediatrics Cantos Krankenhaus Bad Mergentheim

• Buchhorn Reiner

  Department Of Paediatrics Cantos Krankenhaus Bad Mergentheim:department Of Paediatric Cardiology And

• Wessel Armin

  Medical Sociology Unit Medical School Hannover

関連論文

• Beta-Blockade Does Not Alter Plasma Cytokine Concentrations and Ventricular Function in Young Adults With Right Ventricular Dysfunction Secondary to Operated Congenital Heart Disease

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