[Proinflammatory Cytokines in Cardiovascular Diseases As Potential Therapeutic Target]

Several lines of evidence suggest that inflammation plays a pathogenic role in the development and progression of congestive heart failure, influencing heart contractility and hypertrophy, promoting apoptosis, and contributing to the myocardial remodeling process. Proinflammatory cytokines are important mediators of immune response, associated with endothelial dysfunction in patients with coronary artery disease or heart failure. The presence, both at tissue level and in the circulation, of increased levels of pro-inflammatory cytokines suggests that immune activation might be a relevant mechanism contributing to cardiac as well as peripheral manifestations of the disease. Traditional cardiovascular drugs have little influence on the cytokine network. Results from randomized, placebo controlled anti-TNF studies suggest lack of effect of such therapy, but the concept of immune modulation is still intensively studied. In this review we evaluate the diagnostic and prognostic value of the activation of proinflammatory cytokines, theirs role in the pathogenesis of the cardiovascular diseases and the new ways of treatment.