Περίληψη:
Hypothalamic axis deregulation is associated with clinical severity and
depression in chronic heart failure (CHF). We investigated the
relationship of serum prolactin, an indicator of hypothalamic axis
function, to neurohomonal/immune activation and depressive symptoms in
CHF as well as its prognostic value.
Serum prolactin was determined in 180 patients with advanced CHF (aged
65 12 years, mean LVEF 27 7) along with natriuretic peptides (BNP),
inflammatory cytokines, endothelial adhesion molecules, 6 min walk test
(6MWT), and the Zung self-rating depression scale (SDS). Patients were
followed for all-cause death or hospitalization for cardiovascular
reasons for up to 8 months. Prolactin levels were significantly
correlated with NYHA class (r 0.394, P 0.001), LVEF (r 0.314, P 0.001),
6MWT (r 0.353, P 0.001), BNP (r 0.374, P 0.001), Zung SDS (r 0.544, P
0.001), interleukin-6 (IL-6) (r 0.451, P 0.001), IL-10 (r 0.426, P
0.001), tumour necrosis factor (TNF)- (r 0.310, P 0.001), soluble Fas (r
0.333, P 0.001), soluble Fas-ligand (r 0.517, P 0.001), soluble
intercellular adhesion molecule-1 (ICAM-1) (r 0.409, P 0.001), and
soluble vascular cell adhesion molecule-1 (VCAM-1) (r 0.480, P 0.001).
During follow-up, 119 patients (66) died or were hospitalized for
cardiovascular events after a median time of 72 days (range 5220 days);
these patients had higher baseline prolactin levels (10.2 5.7 vs. 6.7
4.3 ng/mL, P 0.001), and a prolactin value 4.5 ng/mL was associated with
a higher rate of death or hospitalization (116 7 vs. 181 11 days, P
0.0001). In multivariate analysis, prolactin levels remained an
independent predictor of death or hospitalization (4.5 vs. 4.5 ng/mL;
odds ratio, 0.368; 95 confidence interval 0.1480.913; P 0.031), along
with BNP (P 0.001) and 6MWT (P 0.020).
Serum prolactin is associated with neurohormonal/immune activation and
depressive symptoms and is an independent predictor of prognosis in
advanced CHF.
Συγγραφείς:
Parissis, John T.
Farmakis, Dimitrios
Fountoulaki, Katerina and
Rigas, Antonios
Nikolaou, Maria
Paraskevaidis, Ioannis A. and
Bistola, Vassiliki
Venetsanou, Koula
Ikonomidis, Ignatios and
Anastasiou-Nana, Maria
Kremastinos, Dimitrios T.
Filippatos,
Gerasimos
