Elevated tumor necrosis factor alpha of blood mononuclear cells in patients with congestive heart failure.

To study the changes of tumor necrosis factor-alpha (TNF-alpha) produced by peripheral blood mononuclear cells (PBMC) of patients with congestive heart failure (CHF), we determined the TNF-alpha concentrations of plasma and culture supernatant of PBMCs in 113 patients with various heart diseases. The results showed that plasma levels of TNF-alpha were significantly higher in CHF patients (n=50, 13.36+/-6.09 pg/ml) and in cachetic CHF patients (n=26, 19.20+/-10.42 pg/ml) than in the controls (n=37, 6.73+/-3.91 ng/ml). The supernatant levels of TNF-alpha in cultured PBMC (PBMC-TNF-alpha) were also significantly elevated in CHF patients (5.77+/-2.11 ng/ml), and even higher in cachetic CHF patients (7.01+/-5.11 ng/ml), as compared with the controls (2.27+/-2.24 ng/ml). There was a significant correlation between levels of PBMC-TNF-alpha and severity of heart failure (r=0.48, P<0.01). But no correlation between PBMC-TNF-alpha and plasma TNF-alpha was observed. These results demonstrate that the expression of TNF-alpha in PBMC is increased in patients with CHF, especially in patients with CHF accompanied by cachexia, suggesting that PBMC-TNF-alpha may be a potential biochemical indicator to evaluate the patients with CHF.