Effect of Bisoprolol on Pro-inflammatory and Anti-inflammatory in Patients with Congestive Heart Failure

OBJECTIVE To investigate the levels of serum concentrations of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α) and interleukin-10(IL-10) in patients with congestive heart failure(CHF),and to evaluate the beneficial effects of bisoprolol on the above variables,cardiac function and exercise endurance.METHODS One hundred patients with CHF(CHF group) and fifty healthy physical examinees(control group) were selected.The serum levels of IL-6,IL-10 and TNF-αwere measured.Patients with CHF were divided randomly into conventional treatment group and bisoprolol group(routine drugs additional bisoprolol) and followed up for 12 weeks.The serum levels of IL-6,IL-10 and TNF-α and cardiac function and six-minute hall walk test were measured pre-treatment and after treatment.RESULTS The main findings in the CHF group were as follows: the serum levels of IL-6,IL-10 and TNF-α were significantly higher than those in the control group(P0.01);the serum levels of IL-6,IL-10 and TNF-αwere positively correlated to each other;the ratios of IL-6/IL-10 and TNF-α/IL-10 increased with increasing the severity of CHF(P0.05);the serum levels of IL-6 and TNF-α were significantly decreased,and the serum level of IL-10 showed a rising trend after treatment as compared with before treatment in the bisoprolol group;the left ventricular ejection fraction(LVEF),fractional shortening(FS) and cardiac output(CO) were significantly increased in the bisoprolol group,but in the control group,only LVEF and FS were improved,while cytokine levels showed no change.Six-minutes walking distance of the paitents in the bisoprolol group were increased signifcantly.CONCLUSION The cytokines were out of balance in the patients with CHF.These disorders were related to the abnormal secretion of inflammatory cytokines.Bisoprolol could improve cardiac function and reduce inflammatory cytokine plasma level in patients with CHF.It might be one of the new mechanisms to improve cardiac function and reverse myocardial remodeling.