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Effect of high- versus low-dose angiotensin converting enzyme inhibition on cytokine levels in chronic heart failure

Lars Gullestad, MD, PhD^*, P.ål Aukrust, MD, PhD^*, Thor Ueland, SIB^a, Terje Espevik, PhD, Gail Yee, SIB, Randall Vagelos, MD, Stig S. Frøland, MD, PhD^* and Michael Fowler, MD, FACC

^a Department of Cardiology, Medical Department B, Rikshospitalet University Hospital, Oslo, Norway
^* Section of Clinical Immunology and Infectious Diseases and Research Institute for Internal Medicine, Medical Department A, Rikshospitalet University Hospital, Oslo, Norway
Institute of Cancer Research and Molecular Biology, the Norwegian University of Science and Technology, Trondheim, Norway
Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California, USA

View larger version (18K): [in a new window]   Figure 1 Plasma levels of IL-6 bioactivity in CHF patients during therapy with low dose (5 mg/daily) and high dose (40 mg/daily) of enalapril at baseline and at end of study. The upper panel (A) shows the absolute concentrations of IL-6 bioactivity during therapy. ***p < 0.001 versus baseline. The lower panel (B) shows the changes in IL-6 bioactivity during therapy (concentration at the end of study—baseline levels). #p < 0.001 versus low-dose group. Data in box plots are given as medians, 25th–75th percentiles and ranges.

View larger version (13K): [in a new window]   Figure 2 Correlation between change in levels of IL-6 bioactivity and change in interventricular septum thickness (IVS) measured by echocardiography during treatment with high-dose enalapril.