Interleukin-1 Signalling Inhibitors in Heart Failure With Preserved and Reduced Ejection Fraction

Aim     To assess circulating levels of interleukin 1 (IL-1), soluble IL-1 receptor type II (sIL-1R2) and IL-1 receptor antagonist (IL-1Ra) in patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in acute decompensated heart failure (ADHF) and in stable condition.

Material and methods            The study included 42 patients with HFpEF and 117 patients with HFrEF admitted for ADHF. After 12 months of follow-up, 31 patients with HFpEF and 84 patients with HFrEF were re-examined. Their condition was assessed as clinically stable. Plasma concentrations of IL-1, IL-1R2, and IL-1Ra were measured in all patients.

Results            In ADHF, IL-1R2 and IL-1Ra concentrations were higher than in stable condition, with IL-1Ra concentrations increasing markedly (3.5 times). Depending on the left ventricular ejection fraction, IL-1 was lower in patients with HFpEF, while IL-1R2 and IL-1Ra were higher than in patients with HFrEF. IL-1 was not detected in stable condition, and differences in IL-1R2 and IL-1Ra concentrations between fractions subsided.

Conclusion     In ADHF, the differences in the concentrations of IL-1 and endogenous inhibitors of IL-1 signaling, IL-1R2 and IL-1βRa, in patients with HFpEF and HFrEF indicated different severity of the inflammatory response in these fractions and more intense neutralization of IL-1 in patients with HFpEF compared to patients with HFrEF, which should be taken into account in the therapeutic blockade of IL-1.

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