Department of Medical Education, Jagiellonian University Medical College, Krakow Poland.
First Department of Cardiology, Invasive Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow Poland.
Kardiol Pol. 2019;77(1):33-39. doi: 10.5603/KP.a2018.0214. Epub 2018 Nov 8.
Heart failure affects patients with normal left ventricular systolic function (heart failure with preserved ejection fraction [HFPEF]) and those with reduced ejection fraction (HFREF). The treatment of HFPEF remains an unresolved issue.
We sought to determinate the relationship between inflammatory markers and left ventricular diastolic dysfunction (LVDD) in a family-based population study.
A total of 303 participants from the general population (55% women, median age 49 years and 45% men, median age 40 years) underwent echocardiography and measurement of serum inflammatory markers: C-reactive protein (CRP), myeloperoxidase (MPO), and interleukin 6 (IL-6).
Serum IL-6 concentration correlated with peak transmitral late diastolic velocity (A) and pulmonary vein systolic-to-di-astolic velocity (S/D) ratio (p < 0.01). Moreover, a significant correlation between IL-6 concentration and E/A ratio and early diastolic peak velocities of the mitral annulus displacement (E') was observed. The association of IL-6 concentration and peak transmitral early diastolic velocities (E) and the E/E' ratio (p < 0.05) was noted in men. In addition, the CRP concentration was shown to have an effect on E/A ratio in women (p < 0.05). A significant correlation between the CRP concentration and S/D ratio was observed both in women (p < 0.01) and men (p < 0.05). No significant correlation was found between the level of MPO and LVDD parameters. Additionally, only one predictive model was identified; E' was found to be dependent on IL-6, age, and heart rate in men (p < 0.001, R2 = 0.611).
The above results suggest that inflammation may lead to the onset of LVDD, probably via vascular endothelial dysfunction.
心力衰竭影响左心室收缩功能正常的患者（射血分数保留的心力衰竭[HFPEF]）和射血分数降低的患者（HFREF）。HFPEF 的治疗仍然是一个未解决的问题。
我们旨在通过基于家族的人群研究确定炎症标志物与左心室舒张功能障碍（LVDD）之间的关系。
共有 303 名来自普通人群的参与者（55%为女性，中位年龄为 49 岁，45%为男性，中位年龄为 40 岁）接受了超声心动图检查和血清炎症标志物测量：C 反应蛋白（CRP）、髓过氧化物酶（MPO）和白细胞介素 6（IL-6）。
血清 IL-6 浓度与二尖瓣瓣口晚期舒张峰速度（A）和肺静脉收缩期至舒张期速度（S/D）比值呈正相关（p<0.01）。此外，还观察到 IL-6 浓度与 E/A 比值以及二尖瓣环早期舒张峰速度（E'）之间存在显著相关性。在男性中，还观察到 IL-6 浓度与二尖瓣瓣口早期舒张峰速度（E）和 E/E'比值呈正相关（p<0.05）。此外，CRP 浓度在女性中对 E/A 比值有影响（p<0.05）。CRP 浓度与 S/D 比值在女性（p<0.01）和男性（p<0.05）中均呈显著相关性。MPO 水平与 LVDD 参数之间无显著相关性。此外，仅确定了一个预测模型；在男性中，E'依赖于 IL-6、年龄和心率（p<0.001，R2=0.611）。
上述结果表明，炎症可能导致 LVDD 的发生，可能是通过血管内皮功能障碍引起的。
