BACKGROUND: Although activation of the complement system in myocardial infarction and cardiopulmonary bypass has been shown to contribute to myocardial injury, its role in congestive heart failure (CHF) is unknown. The purpose of this study was to determine the presence of terminal complement activation and its relation to clinical outcomes in patients with CHF. METHODS: We measured serum levels of the terminal complement complex C5b-9 in 36 patients with symptomatic heart failure and left ventricular ejection fraction <40%. We compared the serum C5b-9 levels of these patients with CHF with a group of 12 age-matched control patients. Combined clinical outcomes (death, urgent heart transplantation, or hospitalization with worsening heart failure) at 6 months were determined. RESULTS: The serum C5b-9 [median (25th to 75th percentiles)] levels in 36 patients with CHF [101.5 ng/mL (40 to 164)] were significantly (P =.003) higher than in the 12 control patients [36.5 ng/mL (22 to 50)]. Significantly more of the patients with CHF with the highest levels of C5b-9 (highest 50th percentile) had New York Heart Association class IV symptoms (67% vs 33%; P =.04) and adverse clinical outcomes by 6 months (56% vs 17%; P =.02) compared with the patients with CHF with lower levels (lowest 50th percentile). CONCLUSIONS: We have described a significant elevation in circulating C5b-9, the terminal complement complex, in patients with symptomatic heart failure and have observed an association between high levels of C5b-9 and near-term adverse events.
BACKGROUND: Although activation of the complement system in myocardial infarction and cardiopulmonary bypass has been shown to contribute to myocardial injury, its role in congestive heart failure (CHF) is unknown. The purpose of this study was to determine the presence of terminal complement activation and its relation to clinical outcomes in patients with CHF. METHODS: We measured serum levels of the terminal complement complex C5b-9 in 36 patients with symptomatic heart failure and left ventricular ejection fraction <40%. We compared the serum C5b-9 levels of these patients with CHF with a group of 12 age-matched control patients. Combined clinical outcomes (death, urgent heart transplantation, or hospitalization with worsening heart failure) at 6 months were determined. RESULTS: The serum C5b-9 [median (25th to 75th percentiles)] levels in 36 patients with CHF [101.5 ng/mL (40 to 164)] were significantly (P =.003) higher than in the 12 control patients [36.5 ng/mL (22 to 50)]. Significantly more of the patients with CHF with the highest levels of C5b-9 (highest 50th percentile) had New York Heart Association class IV symptoms (67% vs 33%; P =.04) and adverse clinical outcomes by 6 months (56% vs 17%; P =.02) compared with the patients with CHF with lower levels (lowest 50th percentile). CONCLUSIONS: We have described a significant elevation in circulating C5b-9, the terminal complement complex, in patients with symptomatic heart failure and have observed an association between high levels of C5b-9 and near-term adverse events.
Authors: C Suffritti; E Tobaldini; R Schiavon; S Strada; L Maggioni; S Mehta; G Sandrone; E Toschi-Dias; M Cicardi; N Montano Journal: Clin Exp Immunol Date: 2017-08-04 Impact factor: 4.330
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Authors: Negar Shahini; Annika E Michelsen; Per H Nilsson; Karin Ekholt; Lars Gullestad; Kaspar Broch; Christen P Dahl; Pål Aukrust; Thor Ueland; Tom Eirik Mollnes; Arne Yndestad; Mieke C Louwe Journal: Sci Rep Date: 2017-02-14 Impact factor: 4.379
Authors: Hilde L Orrem; Per H Nilsson; Søren E Pischke; Guro Grindheim; Peter Garred; Ingebjørg Seljeflot; Trygve Husebye; Pål Aukrust; Arne Yndestad; Geir Ø Andersen; Andreas Barratt-Due; Tom E Mollnes Journal: ESC Heart Fail Date: 2018-02-09
Authors: Zoltán Prohászka; Lea Munthe-Fog; Thor Ueland; Timea Gombos; Arne Yndestad; Zsolt Förhécz; Mikkel-Ole Skjoedt; Zoltan Pozsonyi; Alice Gustavsen; Lívia Jánoskuti; István Karádi; Lars Gullestad; Christen P Dahl; Erik T Askevold; George Füst; Pål Aukrust; Tom E Mollnes; Peter Garred Journal: PLoS One Date: 2013-04-15 Impact factor: 3.240