[Carriage of A Allele of Polymorphic Marker G(-238)A of TNF-alfa Gene Is Associated With Unfavorable Prognosis in Patients With Chronic Systolic Heart Failure]. to elucidate association between polymorphic markers of interleukin- 6 (Il-6) and tumor necrosis factor (TNF) genes and unfavorable outcomes in patients with chronic heart failure (CHF).


 We determined levels of TNF and Il-6 and genotypes of polymorphic markers G(-238)A of TNF gene (rs361525) and G(-174)C of IL-6 gene (rs1800795) in 151 patients (mean age 64.5 years) hospitalized because of decompensation of systolic CHF (left ventricular ejection fraction less or equal 40%) after stabilization of their state.  Unfavorable outcomes were registered during follow-up for 2 years.


 Mean levels of NT-proBNP, Il-6, and TNF were 2481.1+/-199.86 fmol/ml, 21.8+/-7.46 rg/ml, and 10.07+/-0.65 rg/ml, respectively.  138 (94.4%), 13 (8.6%) and 0 patients were carriers of genotypes GG, AG, and AA of polymorphic marker G(-238)A of TNF gene, respectively; 54 (35.8%), 69 (45.7%), and 28 (18.5%) patients carried genotypes GG, GC, and of polymorphic marker G(-174)C gene IL-6, respectively.  There was no association between Il-6, TNF levels and carriage of either of genotypes as well as unfavorable clinical course of CHF.  Mean survival time before repetitive episode of CHF decompensation (including lethal one) was significantly shorter among carriers of A allele compared with carriers of G allele of polymorphic marker G(-238)A of TNF gene (243+/-97.7 and 947+/-78 days, respectively, =0.018).  Mean time before all cause death was also shorter in carriers of A compared with carriers of G allele (289+/-122.9 and 1039+/-73.3 days, respectively, p=0.03).  The studied polymorphism of IL-6 gene had no prognostic value.


 CONCLUSION
 We obtained data on association between carriage of A allele of polymorphic marker G(-238)A of TNF gene and unfavorable prognosis in patients with CHF and inpraired left ventricular systolic function.
C