Altitude Difference Of TNF-α,AngⅡ, BNP In The Elderly Patients With Congestive Heart Failure And Their Effects Ventricular Remodeling

Objective: The altitude difference(2260 m, 3300-3500 m) of serum tumer necrosis factor-α(TNF-α),angiotensinⅡ( AngⅡ),B-type natriuretic peptid(BNP) in the elderly patients(≥65 years old)with congestive heart failure(CHF) was to study, and to evaluate the effect on left ventricular mass index(LVMI), mean wall stress(MWS) and cardiac function. Methods: Serum TNF-α, AngⅡ and BNP in 48 CHF patients from high altitude(3300-3500 m)were studied and compared with 62 CHF patients from moderate altitude(2260 m), Left ventricular ejection fraction(LVEF) by echocardiography, LVMI and MWS were calculated. Results: The levels of TNF-α, AngⅡ, BNP) and LVMI, MWS in CHF patients lived at 3300-3500 m were higher than those, AngⅡ, BNP and LVMI, MWSat 2260 m. With the increase of disease severity, the levels of TNF-α, Ang Ⅱ,BNP and LVMI,MWS significantly increased; there was a positive correlation between LVMI,MWS and the levels of TNF-α, AngⅡ,BNP(P<0.01).Conclusion: With the increase of altitude, ventricular remodeling in CHF change severely. The changes LVMI and MWS were more related to high serum levels of TNF-α and AngⅡ. Increasing in the levels of BNP were more related to high LVMI and MWS. At high altitude, increasing in the levels of TNF-α and AngⅡ play roles in pathophysiological and pathogenetic mechanism of ventricular remodeling in CHF, and correlated with the severity degree of ventricular remodeling in CHF.