Abstract 19229: IL-18 a Powerful Activator of B-cells is Associated With Mortality in Acute Decompensated Heart Failure
Background: Pre-clinical studies have demonstrated that in acute heart failure B-cell cytokines are elevated and these are associated with worsening of the heart failure state. The association of cytokines with markers of cardiac injury is not well established. Therefore we aim to determine if specific cytokines are present during an ADHF episode and its association with cardiac biomarkers and mortality.
Methods: We studied 27 sequential patients admitted with ADHF. Serum samples within 24 hours of admission were analyzed. Using a Procarta multiplex cytokine panel assay (Affymetrix/eBioscience) we measured the following cytokines: INF-γ, IL-12, IL-13, IL-1β, IL-2, TNF- α, IL-4, IL-5, IL-6, GM-CSF and IL-18. Data was retrieved from patient charts and the primary endpoint was mortality within 1 year. We constructed AUC curves to determine optimal cut-off values and p-values ≤ 0.05 were considered significant.
Results: Mean age was 79 ± 9, 19 were Caucasian, 21 male, and 15 had heart failure with reduced ejection fraction. We obtained measurable levels for the following cytokines IL-18, INF-γ, IL-6, IL-1β and IL-4 while IL-12, IL-13 TNF- α, IL-5, and GM-CSF had undetectable levels. We found increased levels of IL-18, and INF-γ in patients who died (p=0.05 and 0.09 respectively). There was a significant correlation between IL-18 and INF- γ (r=0.818, p-value= 0.0001) and IL-18 and BNP levels (r=0.392, p-value= 0.04).There was significantly increased mortality in patients with IL-18 >120 pg/ml. (figure)
Conclusion: Both IL-18 and INF- γ are cytokines related to B-cell differentiation, activation and plasma cell production and they are associated with increased mortality in patients with ADHF. Additionally, there was a positive correlation between IL-18 and BNP levels and may add prognostic value in HF patients. These findings suggest a potential role of B-cells in outcomes of acute decompensated heart failure.
Author Disclosures: A.M. Cordero-Reyes: None. K.A. Youker: None. A. Soliman: None. M. El-Beheary: None. A. Bhimaraj: None. B.H. Trachtenberg: None. G. Ashrith: None. V. Nambi: None. G. Torre-Amione: None. J.D. Estep: None.
- © 2014 by American Heart Association, Inc.