In:
Circulation: Heart Failure, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 8 ( 2018-08)
Abstract:
Enhanced inflammation may lead to exercise intolerance in heart failure with preserved ejection fraction. The aim of the current study was to determine whether IL (interleukin)-1 blockade with anakinra improved cardiorespiratory fitness in heart failure with preserved ejection fraction. Methods and Results Thirty-one patients with heart failure with preserved ejection fraction and CRP (C-reactive protein) 〉 2 mg/L were randomized to anakinra (100 mg subcutaneously daily, N=21) or placebo (N=10) for 12 weeks. We measured peak oxygen consumption (V o 2 ), ventilatory efficiency (V E /V co 2 slope), and high-sensitivity CRP and NT-proBNP (N-terminal pro-B-type natriuretic peptide) at 4, 12, and 24 weeks. Twenty-eight patients completed ≥2 visits, 18 women (64%), 27 (96%) obese. There were no differences in peak V o 2 or V E /V co 2 slope between groups at baseline. Peak V o 2 was not changed after 12 weeks of anakinra (from 13.6 [11.8–18.0] to 14.2 [11.2–18.5] mL·kg −1 ·min −1 , P =0.89), or placebo (14.9 [11.7–17.2] to 15.0 [13.8–16.9] mL·kg −1 ·min −1 , P =0.40), without significant between-group differences in changes at 12 weeks (−0.4 [95% CI, −2.2 to +1.4], P =0.64). V E /V co 2 slope was also unchanged with anakinra (from 28.3 [27.2–33.0] to 30.5 [26.3–32.8] , P =0.97) or placebo (from 31.6 [27.3–36.9] to 31.2 [27.8–33.4] , P =0.78), without significant between-group differences in changes at 12 weeks (+1.2 [95% CI, −1.8 to +4.3], P =0.97). Within the anakinra-treated patients, high-sensitivity CRP and NT-proBNP levels were lower at 4 weeks compared with baseline ( P =0.026 and P =0.022 versus placebo [between-group analysis], respectively). Conclusions Treatment with anakinra for 12 weeks failed to improve peak V o 2 and V E /V co 2 slope in a group of obese heart failure with preserved ejection fraction patients. The favorable trends in high-sensitivity CRP and NT-proBNP with anakinra deserve exploration in future studies. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02173548.
Type of Medium:
Online Resource
ISSN:
1941-3289
,
1941-3297
DOI:
10.1161/CIRCHEARTFAILURE.118.005036
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
2428100-1
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