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在一个基于人群的老年男性和女性样本中,炎症标志物与左心室肥厚和舒张功能障碍相关。

Inflammatory markers are associated with left ventricular hypertrophy and diastolic dysfunction in a population-based sample of elderly men and women.

机构信息

Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden.

出版信息

J Hum Hypertens. 2013 Jan;27(1):13-7. doi: 10.1038/jhh.2011.113. Epub 2012 Jan 12.

Abstract

Markers of inflammation have previously been related to left ventricular (LV) hypertrophy (LVH) in uremic and hypertensive patients. The present study investigated inflammatory markers in relation to LV geometry and diastolic function in a population of elderly persons. In the population-based Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study (1016 men and women 70 years of age), echocardiograms to determine relative wall thickness (RWT), LV mass index (LVMI) and the E/A-ratio were obtained. Based on RWT and LVMI, four geometric subgroups were defined; normal, concentric remodeling, eccentric and concentric LVH. In all, 10 circulating inflammatory markers were measured. Higher levels of high sensitive C-reactive protein (hsCRP) and E-selectin were seen in the three abnormal geometry groups than in the normal group adjusting for gender, body mass index, systolic and diastolic blood pressure and use of antihypertensive medication. Higher level of inter-cellular adhesion molecule 1 (ICAM-1), vascular cell adhesion protein 1 (VCAM-1) and P-selectin were only seen in concentric LVH. Levels of tumor necrosis factor-alpha, interleukin-6, l-selectin, monocyte chemotactic protein-1 and leukocyte count did not differ between the LV groups. l-selectin and hsCRP were related to the E/A-ratio. The adhesion molecules; E-selectin, ICAM-1, VCAM-1, P-selectin and hsCRP were elevated in elderly persons with abnormal LV geometry, especially in concentric LVH, after adjusting for hypertension and obesity. l-selectin and hsCRP were related to LV diastolic function. Further studies are motivated to investigate a pathogenetic role of inflammation for abnormal LV geometry and function.

摘要

先前的研究表明,炎症标志物与尿毒症和高血压患者的左心室(LV)肥厚(LVH)有关。本研究调查了炎症标志物与老年人群 LV 几何形状和舒张功能的关系。在基于人群的乌普萨拉老年人血管研究(PIVUS)研究(1016 名 70 岁的男性和女性)中,进行了超声心动图检查以确定相对壁厚度(RWT)、LV 质量指数(LVMI)和 E/A 比值。根据 RWT 和 LVMI,定义了四个几何亚组;正常、同心重构、偏心和同心 LVH。共测量了 10 种循环炎症标志物。在调整性别、体重指数、收缩压和舒张压以及使用抗高血压药物后,高敏 C 反应蛋白(hsCRP)和 E-选择素在三个异常几何组中的水平高于正常组。只有在同心 LVH 中,细胞间黏附分子 1(ICAM-1)、血管细胞黏附蛋白 1(VCAM-1)和 P-选择素的水平更高。肿瘤坏死因子-α、白细胞介素-6、l-选择素、单核细胞趋化蛋白-1和白细胞计数在 LV 组之间没有差异。l-选择素和 hsCRP 与 E/A 比值有关。在调整高血压和肥胖症后,黏附分子;E-选择素、ICAM-1、VCAM-1、P-选择素和 hsCRP 在 LV 几何形状异常的老年人中升高,尤其是在同心 LVH 中。l-选择素和 hsCRP 与 LV 舒张功能有关。进一步的研究旨在探讨炎症对异常 LV 几何形状和功能的发病机制作用。

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