Author + information
Serum levels of neopterin, an immune modulator secreted by activated macrophages. The relationship between neopterin and the risk of HF has yet to be investigated on a large scale. The level of neopterin elevated in patients with advanced systolic heart failure compared with control subjects. The present study assessed the relationship between neopterin, a novel marker of monocyte activation, and risk of hospitalization for HF and mortality.
The examined group was composed of 54 patients with NYHA class III and IV advanced heart failure and 44 healthy volunteers. All patients medical history was taken. Physical examination and echocardiographic examinations were performed. Neopterin concentration in blood serum was determined with a radioimmunological assay. Twelve months after the patients had left the hospital, their hospital administration, clinical symptoms of heart failure and mortality were evaluated.
The mean neopterin levels were significantly higher with heart failure patients compared with control group. The concentration of neopterin was statistically higher at twenty nine (53,7%) patient whom administer to hospital with decompased heart failure attacks during follow up (p=0.028). Concentration of neopterin in patient with class IV NYHA of heart failure was significantly higher than in group of patient with class III (p>0,001). The neopterin levels were statistically higher at patients who died (35,1%), (p>0,01). On multiple regression analysis, neopterin levels (p=0.02), ejection fraction (p>0.001), and hospital administration (p>0.001) were independent predictors of adverse events.
Serum neopterin is an independent predictor of morbidity in patients with advanced heart failure. This marker of macrophage activation may be useful determination prognosis in patients with advanced heart failure patients.