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Interleukin‐6 Levels are Inversely Correlated with Heart Rate Variability in Patients with Decompensated Heart Failure
Author(s) -
ARONSON DORON,
MITTLEMAN MURRAY A.,
BURGER ANDREW J.
Publication year - 2001
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2001.00294.x
Subject(s) - medicine , heart rate variability , heart failure , cardiology , autonomic nervous system , pathogenesis , interleukin 6 , cytokine , heart rate , endocrinology , blood pressure
Interleukin‐6 and Heart Rate Variability.Introduction : Increased local and systemic elaboration of cytokines have an important role in the pathogenesis of congestive heart failure (CHF) through diverse mechanisms. Because cytokines are known to act at the neuronal level in both the peripheral and central nervous system, we sought to determine whether increased cytokine levels are associated with the autonomic dysfunction that characterizes CHF. Methods and Results : We studied 64 patients admitted for decompensated CHF ( mean age 59 ± 12 years ). Autonomic function was assessed using time– and frequency‐domain heart rate variability (HRV) measures, obtained from 24‐hour Holter recordings. In addition, norepinephrine, tumor necrosis factor‐α (TNF‐α), and interleukin‐6 (IL‐6) were measured in all patients. TNF‐α levels did not correlate with any of the HRV measures. IL‐6 inversely correlated with the time‐domain parameters of standard deviation of RR intervals (SDNN) ( r =−0.36, P = 0.004 ) and standard deviation of all 5–minute mean RR intervals (SDANN) ( r =−0.39, P = 0.001 ), and with the frequency‐domain parameters of total power (TP) ( r =−0.37, P = 0.003 ) and ultralow‐frequency (ULF) power ( r =−0.43, P = 0.001 ). No correlation was found between IL‐6 and indices of parasympathetic modulation. Using multiple linear regression models, adjusting for clinical variables and drug therapies, the strong inverse relationship between IL‐6 and SDNN ( P = 0.006 ), SDANN ( P = 0.001 ), TP ( P = 0.04 ), and ULF power ( P = 0.0007 ) persisted. Conclusion : Reduction of long‐term HRV indices is associated with increased levels of IL‐6 in patients with decompensated heart failure. The ability of long‐term HRV parameters to better reflect activation of diverse hormonal systems may explain their greater prognostic power for risk stratification in patients with CHF.