The Relationship between Tumor Necrosis Factor Alpha and Left Ventricular Diastolic Function

INTRODUCTION: Left ventricular (LV) diastolic dysfunction is a common condition. Tumor necrosis factor (TNF) alpha is an inflammatory cytokine that plays a role in the development of cardiac structural changes leading to LV diastolic dysfunction. The aim of this study was to examine the relationship between serum levels of TNF alpha levels and LV diastolic function. METHODS: A case–control study that included 40 patients with echocardiographic evidence of LV diastolic dysfunction and 40 healthy controls. Standard transthoracic echocardiography was performed to assess LV and left atrial volumes, systolic and diastolic function according to the current recommendations. Serum TNF alpha levels were assessed using a specific enzyme-linked immunosorbent assay kit. RESULTS: Mean serum TNF alpha level was significantly higher in the study group 3.48 ± 1.06 versus 1.22 ± 0.36 pg/ml in the control group, P < 0.001. It was also higher in patients with Grade 2 diastolic dysfunction (n = 16) 3.91 ± 1.21 versus 3.18 ± 0.86 pg/ml in those with Grade 1 diastolic dysfunction (n = 24), P = 0.03. TNF alpha showed a strong correlation with indexed left atrial volume (LAVI) in the study group but not in controls. Mean serum TNF showed a trend toward increase with worsening heart failure symptoms in the form of increased the New York Heart Association functional class. CONCLUSION: Serum TNF alpha level is elevated in patients with LV diastolic dysfunction and is correlated to LAVI in such patients. Patients with Grade 2 diastolic dysfunction have higher serum levels of TNF alpha compared to those with Grade 1 diastolic dysfunction. TNF alpha levels increase with worsening heart failure symptoms.