[Immune mechanisms of inflammation in dilated cardiomyopathy].

AIM

To study immune mechanisms of inflammation in dilated cardiomyopathy (DCM).

MATERIALS AND METHODS

The study of main markers of immune activation was conducted in 44 patients with DCM with stage I - IIB and NYHA functional class (FC) I - IV chronic heart failure (CHF). Among them there were 42 men (95%) and 2 women (5%) in the age from 22 to 61 years. Mean age was 43(10) years. According to FC the patients were distributed in the following way: FC I--10 (23%), FC II--9 (20%), FC III--13 (30%), FC IV--12 (27%). EchoCG was carried out by standard recommendations with assessment of systolic and diastolic function of LV. Measurement of CRP, IgG, IgA, IgM was based on nephelometric method of detection. Content of Il-6, Il-18, Il-10, Il-10, sIl-2R, Il-8, IFN-gamma in blood serum was measured by the method of immunoenzyme analysis.

RESULTS

Elevation of levels of CRP, sIl-2R, Il-8 was established in DCM, what evidenced for the presence of inflammatory process. In the group of patients with DCM with rhythm disturbances (predominantly of atrial fibrillation type) elevation of levels of IFN-gamma, CRP was noted what probably was related to Th-1 type of inflammatory reaction. It was revealed that disturbances of diastolic function of the heart had inflammatory genesis (IFN-gamma correlated with parameter of diastolic function DT; elevation of Il-6 level was found in restrictive type of diastolic function).

CONCLUSION

Elevation of proinflammatory factors in DCM evidence for the presence of inflammatory process. there exist a link between elevated level of mediators of inflammation and complications of the disease--arrhythmia, worsening of heart failure class, deranged diastolic function of the heart.