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(Circulation. 1998;97:1382-1391.)
© 1998 American Heart Association, Inc.


Basic Science Reports

Pathophysiologically Relevant Concentrations of Tumor Necrosis Factor-{alpha} Promote Progressive Left Ventricular Dysfunction and Remodeling in Rats

Biykem Bozkurt, MD; Scott B. Kribbs, BS; Fred J. Clubb, Jr, DVM, PhD; Lloyd H. Michael, PhD; Vladimir V. Didenko, PhD; Peter J. Hornsby, PhD; Yukihiro Seta, MD; Hakan Oral, MD; Francis G. Spinale, MD, PhD; ; Douglas L. Mann, MD

From the Cardiology Section, Department of Medicine, Veterans Administration Medical Center (B.B., Y.S., H.O., D.L.M.), Cardiovascular Sciences (L.H.M.), and the Department of Cell Biology, Huffington Aging Center (V.V.D., P.J.H.), Baylor College of Medicine, Houston, Tex; the Department of Surgery, Medical University of South Carolina, Charleston (S.B.K., F.G.S.); and the Texas Heart Institute, Houston, Tex (F.J.C.).

Background—Although patients with heart failure express elevated circulating levels of tumor necrosis factor-{alpha} (TNF-{alpha}) in their peripheral circulation, the structural and functional effects of circulating levels of pathophysiologically relevant concentrations of TNF-{alpha} on the heart are not known.

Methods and Results—Osmotic infusion pumps containing either diluent or TNF-{alpha} were implanted into the peritoneal cavity of rats. The rate of TNF-{alpha} infusion was titrated to obtain systemic levels of biologically active TNF-{alpha} comparable to those reported in patients with heart failure ({approx}80 to 100 U/mL), and the animals were examined serially for 15 days. Two-dimensional echocardiography was used to assess changes in left ventricular (LV) structure (remodeling) and LV function. Video edge detection was used to assess isolated cell mechanics, and standard histological techniques were used to assess changes in the volume composition of LV cardiac myocytes and the extracellular matrix. The reversibility of cytokine-induced effects was determined either by removal of the osmotic infusion pumps on day 15 or by treatment of the animals with a soluble TNF-{alpha} antagonist (TNFR:Fc). The results of this study show that a continuous infusion of TNF-{alpha} led to a time-dependent depression in LV function, cardiac myocyte shortening, and LV dilation that were at least partially reversible by removal of the osmotic infusion pumps or treatment of the animals with TNFR:Fc.

Conclusions—These studies suggest that pathophysiologically relevant concentrations of TNF-{alpha} are sufficient to mimic certain aspects of the phenotype observed in experimental and clinical models of heart failure.


Key Words: heart failure • remodeling • contractility • cytokines




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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
R. B. Felder, J. Francis, Z.-H. Zhang, S.-G. Wei, R. M. Weiss, and A. K. Johnson
Heart failure and the brain: new perspectives
Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2003; 284(2): R259 - R276.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
J. Francis, R. M. Weiss, A. K. Johnson, and R. B. Felder
Central mineralocorticoid receptor blockade decreases plasma TNF-alpha after coronary artery ligation in rats
Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2003; 284(2): R328 - R335.
[Abstract] [Full Text] [PDF]


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Physiol. Rev.Home page
D. L. Brutsaert
Cardiac Endothelial-Myocardial Signaling: Its Role in Cardiac Growth, Contractile Performance, and Rhythmicity
Physiol Rev, January 1, 2003; 83(1): 59 - 115.
[Abstract] [Full Text] [PDF]


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HeartHome page
P A Henriksen and D E Newby
Therapeutic inhibition of tumour necrosis factor {alpha} in patients with heart failure: cooling an inflamed heart
Heart, January 1, 2003; 89(1): 14 - 18.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
D. M. Kaye, M. M. Parnell, and B. A. Ahlers
Reduced Myocardial and Systemic L-Arginine Uptake in Heart Failure
Circ. Res., December 13, 2002; 91(12): 1198 - 1203.
[Abstract] [Full Text] [PDF]


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Eur J Heart FailHome page
P. J. Pugh, R. D. Jones, T.H. Jones, and K. S. Channer
Heart failure as an inflammatory condition: potential role for androgens as immune modulators
Eur J Heart Fail, December 1, 2002; 4(6): 673 - 680.
[Abstract] [Full Text] [PDF]


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Eur Heart J SupplHome page
S.B. Felix, A. Staudt, and G. Baumann
Immunoadsorption as a new therapeutic principle for treatment of dilated cardiomyopathy
Eur. Heart J. Suppl., December 1, 2002; 4(suppl_I): I63 - I68.
[Abstract] [PDF]


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Circ. Res.Home page
D. L. Mann
Inflammatory Mediators and the Failing Heart: Past, Present, and the Foreseeable Future
Circ. Res., November 29, 2002; 91(11): 988 - 998.
[Abstract] [Full Text] [PDF]


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Am. J. Pathol.Home page
Y. Sun, J. Zhang, L. Lu, S. S. Chen, M. T. Quinn, and K. T. Weber
Aldosterone-Induced Inflammation in the Rat Heart : Role of Oxidative Stress
Am. J. Pathol., November 1, 2002; 161(5): 1773 - 1781.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
R. Nishio, S. Sasayama, and A. Matsumori
Left ventricular pressure-volume relationship in a murine model of congestive heart failure due to acute viral myocarditis
J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1506 - 1514.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
R. M Smith, N. Suleman, J. McCarthy, and M. N Sack
Classic ischemic but not pharmacologic preconditioning is abrogated following genetic ablation of the TNF{alpha} gene
Cardiovasc Res, August 15, 2002; 55(3): 553 - 560.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
S. Nemoto, J. G. Vallejo, P. Knuefermann, A. Misra, G. Defreitas, B. A. Carabello, and D. L. Mann
Escherichia coli LPS-induced LV dysfunction: role of toll-like receptor-4 in the adult heart
Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2316 - H2323.
[Abstract] [Full Text] [PDF]


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Alcohol AlcoholHome page
H. Jankala, C. J. P. Eriksson, K. K. Eklund, M. Harkonen, and T. Maki
COMBINED CALCIUM CARBIMIDE AND ETHANOL TREATMENT INDUCES HIGH BLOOD ACETALDEHYDE LEVELS, MYOCARDIAL APOPTOSIS AND ALTERED EXPRESSION OF APOPTOSIS-REGULATING GENES IN RAT
Alcohol Alcohol., May 1, 2002; 37(3): 222 - 228.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. B. Sawyer and J. Loscalzo
Myocardial Hibernation: Restorative or Preterminal Sleep?
Circulation, April 2, 2002; 105(13): 1517 - 1519.
[Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
W. S. Bradham, G. Moe, K. A. Wendt, A. A. Scott, A. Konig, M. Romanova, G. Naik, and F. G. Spinale
TNF-alpha and myocardial matrix metalloproteinases in heart failure: relationship to LV remodeling
Am J Physiol Heart Circ Physiol, April 1, 2002; 282(4): H1288 - H1295.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
V. Adams, B. Nehrhoff, U. Spate, A. Linke, P. C Schulze, A. Baur, S. Gielen, R. Hambrecht, and G. Schuler
Induction of iNOS expression in skeletal muscle by IL-1{beta} and NF{kappa}B activation: an in vitro and in vivo study
Cardiovasc Res, April 1, 2002; 54(1): 95 - 104.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
A. Yndestad, J. Kristian Damas, H. Geir Eiken, T. Holm, T. Haug, S. Simonsen, S. S. Froland, L. Gullestad, and P. Aukrust
Increased gene expression of tumor necrosis factor superfamily ligands in peripheral blood mononuclear cells during chronic heart failure
Cardiovasc Res, April 1, 2002; 54(1): 175 - 182.
[Abstract] [Full Text] [PDF]


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JEMHome page
T. R. Bernik, S. G. Friedman, M. Ochani, R. DiRaimo, L. Ulloa, H. Yang, S. Sudan, C. J. Czura, S. M. Ivanova, and K. J. Tracey
Pharmacological Stimulation of the Cholinergic Antiinflammatory Pathway
J. Exp. Med., March 18, 2002; 195(6): 781 - 788.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
W. S. Bradham, B. Bozkurt, H. Gunasinghe, D. Mann, and F. G. Spinale
Tumor necrosis factor-alpha and myocardial remodeling in progression of heart failure: a current perspective
Cardiovasc Res, March 1, 2002; 53(4): 822 - 830.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
S. Adamopoulos, J. Parissis, D. Karatzas, C. Kroupis, M. Georgiadis, G. Karavolias, J. Paraskevaidis, K. Koniavitou, A. J. S. Coats, and D. T. Kremastinos
Physical training modulates proinflammatory cytokines and the soluble Fas/soluble Fasligand system in patients with chronic heart failure
J. Am. Coll. Cardiol., February 20, 2002; 39(4): 653 - 663.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
R. J. Scheubel, B. Bartling, A. Simm, R.-E. Silber, K. Drogaris, D. Darmer, and J. Holtz
Apoptotic pathway activation from mitochondria and death receptors without caspase-3 cleavage in failing human myocardium: Fragile balance of myocyte survival?
J. Am. Coll. Cardiol., February 6, 2002; 39(3): 481 - 488.
[Abstract] [Full Text] [PDF]


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HeartHome page
C G Densem, I V Hutchinson, N Yonan, and N H Brooks
Tumour necrosis factor {alpha} gene polymorphism: a predisposing factor to non-ischaemic myocardial dysfunction?
Heart, February 1, 2002; 87(2): 153 - 155.
[Abstract] [Full Text] [PDF]


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Cold Spring Harb Symp Quant BiolHome page
D.L. MANN
The Yin/Yang of Innate Stress Responses in the Heart
Cold Spring Harb Symp Quant Biol, January 1, 2002; 67(0): 363 - 370.
[Abstract] [PDF]


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Cardiovasc ResHome page
V. Stangl, G. Baumann, K. Stangl, and S. B Felix
Negative inotropic mediators released from the heart after myocardial ischaemia-reperfusion
Cardiovasc Res, January 1, 2002; 53(1): 12 - 30.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
R. Sodian, M. Loebe, C. Schmitt, E. V. Potapov, H. Siniawski, J. Muller, H. Hausmann, H. R. Zurbruegg, Y. Weng, and R. Hetzer
Decreased plasma concentration of brain natriuretic peptide as a potential indicator of cardiac recovery in patients supported by mechanical circulatory assist systems
J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1942 - 1949.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
M.-W. Hwang, A. Matsumori, Y. Furukawa, K. Ono, M. Okada, A. Iwasaki, M. Hara, T. Miyamoto, M. Touma, and S. Sasayama
Neutralization of interleukin-1{beta} in the acute phase of myocardial infarction promotes the progression of left ventricular remodeling
J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1546 - 1553.
[Abstract] [Full Text] [PDF]


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CirculationHome page
E. J. Birks, N. Latif, V. Owen, C. Bowles, L. E. Felkin, A. J. Mullen, A. Khaghani, P. J.R. Barton, J. M. Polak, J. R. Pepper, et al.
Quantitative Myocardial Cytokine Expression and Activation of the Apoptotic Pathway in Patients Who Require Left Ventricular Assist Devices
Circulation, September 18, 2001; 104 (2009): I-233 - I-240.
[Abstract] [Full Text] [PDF]


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CirculationHome page
T. Kadokami, C. Frye, B. Lemster, C. L. Wagner, A. M. Feldman, and C. F. McTiernan
Anti-Tumor Necrosis Factor-{alpha} Antibody Limits Heart Failure in a Transgenic Model
Circulation, September 4, 2001; 104(10): 1094 - 1097.
[Abstract] [Full Text] [PDF]


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CirculationHome page
N. Sivasubramanian, M. L. Coker, K. M. Kurrelmeyer, W. R. MacLellan, F. J. DeMayo, F. G. Spinale, and D. L. Mann
Left Ventricular Remodeling in Transgenic Mice With Cardiac Restricted Overexpression of Tumor Necrosis Factor
Circulation, August 14, 2001; 104(7): 826 - 831.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
J. K. Damas, L. Gullestad, H. Aass, S. Simonsen, J. G. Fjeld, L. Wikeby, T. Ueland, H. G. Eiken, S. S. Froland, and P.a. Aukrust
Enhanced gene expression of chemokines and their corresponding receptors in mononuclear blood cells in chronic heart failure--modulatory effect of intravenous immunoglobulin
J. Am. Coll. Cardiol., July 1, 2001; 38(1): 187 - 193.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
E. Braunwald
Congestive heart failure: a half century perspective
Eur. Heart J., May 2, 2001; 22(10): 825 - 836.
[PDF]