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原发性高血压患者的心脏功能障碍取决于全身性促炎影响:一项回顾性临床病理生理学研究。

Heart Dysfunction in Essential Hypertension Depends on Systemic Proinflammatory Influences: A Retrospective Clinical Pathophysiological Study.

作者信息

Barsukov Anton V, Korovin Alexander E, Churilov Leonid P, Borisova Ekaterina V, Tovpeko Dmitry V

机构信息

Kardio Klinika, 196105 St. Petersburg, Russia.

Laboratory of the Microangiopathic Mechanisms of Atherogenesis, Department of Pathology, Saint Petersburg State University, 199034 St. Petersburg, Russia.

出版信息

Pathophysiology. 2022 Aug 7;29(3):453-468. doi: 10.3390/pathophysiology29030036.

Abstract

Low-intensity systemic inflammation is an important element of heart failure pathogenesis. The aim of this study is to assess proinflammatory status serum indicators (C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6)) in middle-aged males (M) and females (F) with essential hypertension (HTN) depending on left ventricular (LV) diastolic dysfunction (LVDD). The main group comprised 55 M and 49 F with the first- to second-severity grade HTN with mild heart failure and a preserved LV ejection fraction ≥50%. Patients had sinus rhythm, first or second-severity degree LVDD, LV hypertrophy, left atrium dilatation, and NT-proBNP > 125 pg/mL. Comparison group: 30 hypertensives without cardiac dysfunction; control group: 31 normotensives. Quantitative features were compared using the Mann−Whitney test, median χ2, ANOVA module. Spearman’s rank correlation coefficients were determined to identify the relationship between the proinflammatory pattern and exercise tolerance. Hypertensive M had markedly higher CRP, TNF-α, and IL-6 levels compared to F. All mean values corresponded to reference range. In patients with second-degree LVDD, CRP, TNF-α, and IL-6 levels were significantly greater than in subjects with first-degree LVDD (both within M and within F samples). Significant negative associations between CRP, IL-6, and TNF-α levels and the 6 min walk test existed in hypertensive M and F. The study demonstrated a close relationship between the proinflammatory pattern and LVDD and exercise tolerance indicators, regardless of the hypertensive patient’s sex.

摘要

低强度全身性炎症是心力衰竭发病机制的一个重要因素。本研究的目的是评估原发性高血压(HTN)的中年男性(M)和女性(F)中,根据左心室(LV)舒张功能障碍(LVDD)情况的促炎状态血清指标(C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6))。主要组包括55名男性和49名女性,患有一至二级严重程度的高血压且伴有轻度心力衰竭,左心室射血分数保留≥50%。患者有窦性心律、一级或二级严重程度的LVDD、左心室肥厚、左心房扩张,且N末端脑钠肽前体(NT-proBNP)>125 pg/mL。比较组:30名无心脏功能障碍的高血压患者;对照组:31名血压正常者。使用曼-惠特尼检验、中位数χ2、方差分析模块比较定量特征。确定斯皮尔曼等级相关系数以识别促炎模式与运动耐量之间的关系。与女性相比,高血压男性的CRP、TNF-α和IL-6水平明显更高。所有平均值均在参考范围内。在二级LVDD患者中,CRP、TNF-α和IL-6水平显著高于一级LVDD患者(在男性和女性样本中均如此)。高血压男性和女性中,CRP、IL-6和TNF-α水平与6分钟步行试验之间存在显著负相关。该研究表明,无论高血压患者的性别如何,促炎模式与LVDD和运动耐量指标之间都存在密切关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/502e/9396991/ad516d4888dd/pathophysiology-29-00036-g001.jpg

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