Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Peking University First Hospital, Beijing, China.
BMC Cardiovasc Disord. 2022 Aug 10;22(1):367. doi: 10.1186/s12872-022-02807-2.
The complement system plays an important role in the development of left ventricular hypertrophy. Complement C1q is an initial component of the classical complement pathway and is related to many inflammatory diseases. We aimed to determine whether there was an association between serum complement C1q and left ventricular hypertrophy induced by coarctation of the aorta (CoA).
Based on whether CoA was combined with a large ventricular septal defect (VSD) or patent ductus arteriosus (PDA), the patients were divided into a simple CoA group (n = 15) and a complex CoA group (n = 13). Meanwhile, we selected simple large VSD (n = 14) patients and normal children (n = 28) as the control group. The serum complement C1q level was compared using immunity transmission turbidity among different groups.
The preoperative content of C1q in the simple CoA group was significantly lower than that in the complex CoA group and normal group (96.97 ± 20.66 vs. 130.73 ± 35.78, 96.97 ± 20.66 vs. 156.21 ± 29.14, P < 0.05). There was no significant difference in the preoperative content of C1q between the complex CoA group and the large VSD group (P > 0.05). There was a negative correlation between the preoperative complement C1q content and the interventricular septal thickness and left ventricular posterior wall thickness (r = - 0.035, r = - 0.288, P < 0.05). The percentage of postoperative decrease in C1q in children with simple CoA or complex CoA was positively correlated with the time of cardiopulmonary bypass and aortic cross clamp, respectively (r = 0.797, r = 0.622, r = 0.898, r = 0.920, P < 0.05). There was no significant difference in the content of preoperative triglycerides (TG), total cholesterol (TCHO), high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C) among the different groups (P > 0.05). In the simple CoA group and complex CoA group, the preoperative complement C1q, TG, TCHO, HDL-C and LDL-C levels were significantly higher than those after the operation (P < 0.05). There was no significant correlation between preoperative complement C1q and TG, TCHO, HDL-C or LDL-C (P > 0.05).
Complement C1q has an inhibitory effect on the formation of left ventricular hypertrophy, which may not be mediated by regulating lipid metabolism. During cardiac surgery, complement C1q may have a protective effect against myocardial injury.
补体系统在左心室肥厚的发展中起着重要作用。补体 C1q 是经典补体途径的初始成分,与许多炎症性疾病有关。我们旨在确定血清补体 C1q 与升主动脉缩窄(CoA)引起的左心室肥厚之间是否存在关联。
根据 CoA 是否合并大室间隔缺损(VSD)或动脉导管未闭(PDA),将患者分为单纯 CoA 组(n=15)和复杂 CoA 组(n=13)。同时,我们选择单纯大 VSD(n=14)患者和正常儿童(n=28)作为对照组。采用免疫透射比浊法比较不同组之间的血清补体 C1q 水平。
单纯 CoA 组术前 C1q 含量明显低于复杂 CoA 组和正常组(96.97±20.66 vs. 130.73±35.78,96.97±20.66 vs. 156.21±29.14,P<0.05)。复杂 CoA 组与大 VSD 组术前 C1q 含量无显著差异(P>0.05)。术前补体 C1q 含量与室间隔厚度和左心室后壁厚度呈负相关(r=-0.035,r=-0.288,P<0.05)。单纯 CoA 或复杂 CoA 患儿术后 C1q 下降百分比与体外循环和主动脉阻断时间呈正相关(r=0.797,r=0.622,r=0.898,r=0.920,P<0.05)。不同组间术前三酰甘油(TG)、总胆固醇(TCHO)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)含量无显著差异(P>0.05)。单纯 CoA 组和复杂 CoA 组术前补体 C1q、TG、TCHO、HDL-C 和 LDL-C 水平均明显高于术后(P<0.05)。术前补体 C1q 与 TG、TCHO、HDL-C 或 LDL-C 无显著相关性(P>0.05)。
补体 C1q 对左心室肥厚的形成有抑制作用,可能不是通过调节脂代谢来介导的。在心脏手术中,补体 C1q 可能对心肌损伤有保护作用。