Paper Type

Master's Thesis


Brooks College of Health

Degree Name

Master of Science in Health Science (MSH)


Clinical & Applied Movement Sciences

NACO controlled Corporate Body

University of North Florida. Department of Clinical & Applied Movement Sciences

First Advisor

Dr. James R. Churilla

Second Advisor

Dr. Michael R. Richardson

Third Advisor

Dr. Tammie M. Johnson

Fourth Advisor

Dr. Robert J. Chilton

Fifth Advisor

Dr. Clinton A. Brawner

Department Chair

Dr. James R. Churilla

College Dean

Dr. Curt L. Lox


Purpose Examine the relationships between high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor-α receptor-1 (sTNF-R1) and the cumulative risk of heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fractions in a diverse, population-based sample. Methods Study sample included 6,814 adult (45-84 years of age) men and women who participated in the Multi-Ethnic Study of Atherosclerosis and were free of cardiovascular disease at baseline. Cox regression was used to calculate the hazard ratios (HR) associated with elevated baseline hs-CRP (> 3-10 mg/L), IL-6 (> 75th percentile) and sTNF-R1 (> 75th percentile) and risk of overall HF, HFrEF (ejection fraction [EF] < 50%), and HFpEF (EF ≥ 50%). Results During ~11.2 years of follow-up there were 178 incident HF diagnoses. Elevated hs-CRP, IL-6 and sTNF-R1 were associated with a significant increased risk of HF overall (HR 1.76; 95% Confidence interval [CI] 1.22-2.52, HR 1.57; 95% 1.07-2.30, and HR 1.91; 95% CI 1.08-3.38, respectively). Elevated hs-CRP was a significant predictor in both HFrEF and HFpEF (HR 2.05; 95% CI 1.26-3.35, and HR 1.89; 95% CI 1.09-3.28, respectively). Baseline IL-6 concentrations were significantly associated with increased risk of HFrEF in nonsmokers only (HR 2.33; 95% CI 1.04-5.23) and of HFpEF in African Americans only (HR 5.89; 95% CI 1.52-22.80).Conclusions In a diverse sample of U.S. adults, elevated hs-CRP, IL-6 and sTNF-R1 were significant predictors of HF. Furthermore, both hs-CRP and IL-6 were significant predictors in HFrEF and HFpEF.