Change And Value Of Serum Adiponectin, Bnp And Tnf-α In Elderly Patients With Chronic Congestive Heart Failue

Objective:The study sought to evaluate the change of serum adiponectin,brain natriuretic peptide (BNP) and tumor necrosis factor-a(TNF-a) in elderly patients with chronic congestive heart failure (CHF),and the relationship between the three cytokins and the prognostic value in CHF.Methods:67 elderly patients with decompensated CHF were evaluated with blood biochemistry,echocardiogram.Serum BNP,adiponectin and TNF-awere determined with ELISA in central laboratory. The controls were 24 elderly patients without CHF. Patients with CHF were followed up in three months, the end point were cardiovascular mortality and rehospitality with decompensated heart failure.Results:The levels of serum BNP were significantly increased in CHF patients compared to control group (156.31±55.41pg/ml vs 91.37±16.93pg/ml P<0.01).Patients with CHF had higher serum adiponetin and TNF-a than controls respectively (17.34±5.67μg/ml vs 9.21±3.22μg/ml P<0.05; 1.96±0.83 ng/ml vs 1.21±0.24 ng/ml P< 0.05).Serum adiponetin levels were significantly related with left ventricular ejective fration(LVEF)(r=-0.656 P<0.001),and serum BNP(r=0.667 P<0.01),and TNF-a (r=0.560 P<0.01).Multiple regressin analysis showed that the variables independently associated with lgadiponetin were BNP,BMI,HDL-C and LDL-C.Serum BNP may be helpful in the prognosis of the cardiovascular event in three months.Area under the curve of ROC was 0.740 [95%CI:0.596～0.885 p<0.05].Serum adiponectin also predicted the cardiovascular event in three months.Area under the curve of ROC was 0.751 [95%CI:0.613～0.887 P=0.031].But serum TNF-a had no value in predicting the cardiovascular events in three months.Conculsions:Serum adiponectin, BNP and TNF-a levels rises in CHF.Serum adiponectin levels were significantly related with severity of ventricular dysfunction in elderly congestive heart failure.Adiponetin may be helpful in predicting the cardiovascular events in three months.