ABSTRACT
Serum tumor necrosis factor-alpha [TNF-alpha] was studied in 84 patients with cachectic chronic heart failure [46 males and 38 females] in addition to 13 healthy volunteers served as controls. The weight, the height, the body mass index, the median circumference, the skin fold thickness and the body fat percentage were used as parameters for the degree of cachexia. Patients were categorized according to underlying etiology of heart failure into group I including 24 patients with rheumatic heart disease [RHD], group II including 20 patients with ischemic heart disease [IHD], group III including 20 patients with cardiomyopathic heart disease and group IV including 20 patients with decompensated corpulmonale. Serum TNF- alpha was significantly higher in all patients [mean +/- SE 125.73 +/- 16.90 pg/ml] than the control group [mean +/- SE 15.94 +/- 2.00 pg/ml], the same level of significance was observed in comparing each group of patients and the control group. When groups of patients were compared with each other, TNF-alpha was statistically higher in group II than group I and group IV. The body fat content percentage was significantly lower in all patients [mean +/- SE 18.2 +/- 0.70] compared with control group [mean +/- SE 22.77 +/- 1.11%]. The findings suggested that the raised level of TNF may play a role in the pathogenesis of cardiac cachexia in patients with chronic heart failure irrespective of their etiology