From the Department of Medicine (M.D.M., V.N., H.D.V., J.A.C.L.), Johns Hopkins University, Baltimore, MD.
Department of Internal Medicine, Federal University of Santa Maria, Rio Grande do Sul, Brazil (M.D.M.).
Hypertension. 2018 Oct;72(4):902-908. doi: 10.1161/HYPERTENSIONAHA.118.11463.
Inflammation promotes adverse ventricular remodeling. T1 mapping has been used to noninvasively assess interstitial myocardial fibrosis. We examined the association of baseline markers of systemic inflammation with interstitial myocardial fibrosis measured by extracellular volume fraction (ECV) and native T1 mapping at 10-year follow-up in the MESA (Multi-Ethnic Study of Atherosclerosis). Seven hundred seventy-two participants had complete baseline data and underwent cardiac magnetic resonance imaging. All analyses were stratified by sex. Multivariable linear regression models were constructed to assess the associations of baseline CRP (C-reactive protein), IL (interleukin)-6, and fibrinogen with native T1 time and ECV. Longer native T1 times and higher percentages of ECV represent increasing myocardial fibrosis. A 1-SD increment of log-transformed IL-6 levels was associated with 0.4% higher ECV in men (β=0.4; P=0.05). CRP and fibrinogen were not associated to ECV. A 1-SD increment in the log-transformed CRP levels was associated with 4.9 ms higher native T1 (β=4.9; P=0.03). In women, the inflammatory markers did not demonstrate association with native T1 nor ECV. Higher IL-6 and CRP levels are associated with increased interstitial myocardial fibrosis assessed by cardiac magnetic resonance in men. However, no inflammatory markers were associated to myocardial fibrosis in women.
炎症促进不良的心室重构。T1 映射已被用于无创评估间质心肌纤维化。我们研究了基线全身性炎症标志物与通过细胞外容积分数 (ECV) 和 10 年随访时的固有 T1 映射测量的间质心肌纤维化之间的关联,这项研究来自于动脉粥样硬化多民族研究 (MESA)。772 名参与者具有完整的基线数据,并接受了心脏磁共振成像。所有分析均按性别分层。构建了多变量线性回归模型,以评估基线 CRP(C 反应蛋白)、IL(白细胞介素)-6 和纤维蛋白原与固有 T1 时间和 ECV 的相关性。固有 T1 时间延长和 ECV 百分比升高代表心肌纤维化增加。男性中,IL-6 水平的对数转换增加 1-SD,与 ECV 增加 0.4%相关(β=0.4;P=0.05)。CRP 和纤维蛋白原与 ECV 无关。CRP 水平的对数转换增加 1-SD,与固有 T1 增加 4.9 ms 相关(β=4.9;P=0.03)。在女性中,炎症标志物与固有 T1 或 ECV 均无相关性。较高的 IL-6 和 CRP 水平与男性心脏磁共振评估的间质心肌纤维化增加相关。然而,在女性中,没有炎症标志物与心肌纤维化相关。