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Tumour necrosis factor α concentration and collateral flow in patients with coronary artery disease and normal systolic left ventricular function
  1. C Seiler,
  2. T Pohl,
  3. M Billinger,
  4. B Meier
  1. Swiss Cardiovascular Center Bern, Cardiology, University Hospital, Bern, Switzerland
  1. Correspondence to:
    Professor Christian Seiler, MD, Swiss Cardiovascular Center Bern, University Hospital, CH-3010 Bern, Switzerland;

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Increased expression of tumour necrosis factor α (TNFα) has been found in cardiac tissue of patients with chronic heart failure, and the failing heart has been suggested as the cause of immune activation.1

Another, less frequently reported facet of the macrophage derived mediator TNFα is its function as an angiogenic factor2 which may be induced by myocardial ischaemia. This pleiotropic cytokine appears to act also as an angioinhibitory factor depending on the concentration, location, and duration of its action.3 So far, there have been no studies in patients with coronary artery disease (CAD) investigating the relation between the potentially angiogenic TNFα and directly measured collateral flow, the latter representing a variable in the course of CAD with considerable impact on its outcome.

The purpose of this study was to test the hypothesis that there is an association between TNFα and collateral flow in patients with CAD and normal systolic ventricular function.



One hundred patients (mean (SD) age 65 (11) years, 70 men, 30 women) with one vessel and two vessel CAD were included in the study. All underwent percutaneous transluminal coronary angioplasty (PTCA) of one stenotic lesion because of symptoms related to stable CAD. Patients were prospectively selected on the basis of the following criteria: (1) no previous infarction in the myocardial area undergoing PTCA; (2) normal left ventricular ejection fraction; (3) no congestive heart failure; (4) no baseline ECG ST segment abnormalities; (5) …

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