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Br Heart J. 1991 November; 66(5): 356–358.
PMCID: PMC1024773

Increased concentrations of tumour necrosis factor in "cachectic" patients with severe chronic heart failure.

Abstract

OBJECTIVE--To ascertain whether patients with cardiac failure and reduced body weight ("cardiac cachexia") have increased circulating concentrations of tumour necrosis factor (cachectin). DESIGN--Patients with cardiac failure were prospectively identified as "cachectic" (body fat less than 27% in men and less than 29% in women measured by skinfold thickness callipers) or "non-cachectic". Tumour necrosis factor was assayed blind to patient group. SETTING--Cardiology unit in a tertiary referral centre. PATIENTS--26 consecutive patients (10 women) (mean age 61) admitted for investigation or treatment of chronic heart failure. All were in New York Heart Association class III or IV. RESULTS--In nine of the 16 cachectic patients the concentration of tumour necrosis factor was increased (mean (SEM) 74 (20) pg/ml) compared with one of the 10 "non-cachectic" patients (22 pg/ml, p less than 0.001). Patients with a raised circulating concentration of tumour necrosis factor weighed significantly less (55.6 (3.5) kg) than those in whom the concentration of tumour necrosis factor was normal (69.0 (4.1) kg) (p = 0.02). CONCLUSIONS--Circulating concentrations of tumour necrosis factor were increased in a significant proportion of patients with chronic heart failure and low body weight. Tumour necrosis factor stimulates catabolism experimentally and it may be a factor in the weight loss seen in patients with "cardiac cachexia".

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ansari A. Syndromes of cardiac cachexia and the cachectic heart: current perspective. Prog Cardiovasc Dis. 1987 Jul-Aug;30(1):45–60. [PubMed]
  • Morrison WL, Edwards RH. Cardiac cachexia. BMJ. 1991 Feb 9;302(6772):301–302. [PMC free article] [PubMed]
  • Beutler B, Cerami A. Cachectin and tumour necrosis factor as two sides of the same biological coin. Nature. 1986 Apr 17;320(6063):584–588. [PubMed]
  • Evans RD, Argilés JM, Williamson DH. Metabolic effects of tumour necrosis factor-alpha (cachectin) and interleukin-1. Clin Sci (Lond) 1989 Oct;77(4):357–364. [PubMed]
  • Starnes HF, Jr, Warren RS, Jeevanandam M, Gabrilove JL, Larchian W, Oettgen HF, Brennan MF. Tumor necrosis factor and the acute metabolic response to tissue injury in man. J Clin Invest. 1988 Oct;82(4):1321–1325. [PMC free article] [PubMed]
  • Blackburn GL, Harvey KB. Nutritional assessment as a routine in clinical medicine. Postgrad Med. 1982 May;71(5):46–63. [PubMed]
  • Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974 Jul;32(1):77–97. [PubMed]
  • Leroux-Roels G, Offner F, Philippé J, Vermeulen A. Influence of blood-collecting systems on concentrations of tumor necrosis factor in serum and plasma. Clin Chem. 1988 Nov;34(11):2373–2374. [PubMed]
  • Levine B, Kalman J, Mayer L, Fillit HM, Packer M. Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med. 1990 Jul 26;323(4):236–241. [PubMed]
  • Balkwill F, Osborne R, Burke F, Naylor S, Talbot D, Durbin H, Tavernier J, Fiers W. Evidence for tumour necrosis factor/cachectin production in cancer. Lancet. 1987 Nov 28;2(8570):1229–1232. [PubMed]
  • Scuderi P, Sterling KE, Lam KS, Finley PR, Ryan KJ, Ray CG, Petersen E, Slymen DJ, Salmon SE. Raised serum levels of tumour necrosis factor in parasitic infections. Lancet. 1986 Dec 13;2(8520):1364–1365. [PubMed]
  • Lähdevirta J, Maury CP, Teppo AM, Repo H. Elevated levels of circulating cachectin/tumor necrosis factor in patients with acquired immunodeficiency syndrome. Am J Med. 1988 Sep;85(3):289–291. [PubMed]
  • Zabel P, Wolter DT, Schönharting MM, Schade UF. Oxpentifylline in endotoxaemia. Lancet. 1989 Dec 23;2(8678-8679):1474–1477. [PubMed]
  • Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, van der Meer JW, Cannon JG, Rogers TS, Klempner MS, Weber PC, et al. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med. 1989 Feb 2;320(5):265–271. [PubMed]
  • Tracey KJ, Vlassara H, Cerami A. Cachectin/tumour necrosis factor. Lancet. 1989 May 20;1(8647):1122–1126. [PubMed]
  • Beutler B, Milsark IW, Cerami AC. Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin. Science. 1985 Aug 30;229(4716):869–871. [PubMed]
  • van der Poll T, Büller HR, ten Cate H, Wortel CH, Bauer KA, van Deventer SJ, Hack CE, Sauerwein HP, Rosenberg RD, ten Cate JW. Activation of coagulation after administration of tumor necrosis factor to normal subjects. N Engl J Med. 1990 Jun 7;322(23):1622–1627. [PubMed]
  • Hocking DC, Phillips PG, Ferro TJ, Johnson A. Mechanisms of pulmonary edema induced by tumor necrosis factor-alpha. Circ Res. 1990 Jul;67(1):68–77. [PubMed]
  • Tracey KJ, Lowry SF, Beutler B, Cerami A, Albert JD, Shires GT. Cachectin/tumor necrosis factor mediates changes of skeletal muscle plasma membrane potential. J Exp Med. 1986 Oct 1;164(4):1368–1373. [PMC free article] [PubMed]
  • Cunnion RE, Parrillo JE. Myocardial dysfunction in sepsis. Recent insights. Chest. 1989 May;95(5):941–945. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Group