Ovchinnikov Artem, Filatova Anastasiya, Potekhina Alexandra, Arefieva Tatiana, Gvozdeva Anna, Ageev Fail, Belyavskiy Evgeny
Laboratory of Myocardial Fibrosis and Heart Failure with Preserved Ejection Fraction, Institute of Clinical Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, 121552 Moscow, Russia.
Department of Clinical Functional Diagnostics, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia.
J Cardiovasc Dev Dis. 2023 Jul 20;10(7):310. doi: 10.3390/jcdd10070310.
(1) Background: Chronic inflammation and fibrosis are key players in cardiac remodeling associated with left ventricular hypertrophy (LVH) and heart failure with a preserved ejection fraction (HFpEF). Monocytes and T-helpers (Th) are involved in both pro-inflammatory and fibrotic processes, while regulatory T-cells (Treg) could be considered to suppress chronic inflammation in the hypertrophied myocardium. We aimed to estimate the relationship between the frequencies of circulating CD4 T-cell and monocyte subpopulations and the variables of left ventricular (LV) diastolic function in patients with LVH depending on the presence of HFpEF. (2) Methods: We enrolled 57 patients with asymptomatic hypertensive LVH ( = 21), or LVH associated with HFpEF ( = 36). A clinical assessment and echocardiographs were analyzed. CD4 Treg, activated Th (Th-act), and monocyte (classical, intermediate, and non-classical) subpopulations were evaluated via direct immunofluorescence and flow cytometry. (3) Results: Patients with HFpEF had a lower Treg/Th-act ratio ( = 0.001). Though asymptomatic patients and patients with HFpEF were comparable in terms of both the total monocyte number and monocyte subsets, there were moderate correlations between intermediate monocyte count and conventional and novel echocardiographic variables of LV diastolic dysfunction in patients with HFpEF. (4) Conclusions: In patients with LVH, the clinical deterioration (transition to HFpEF) and progression of LV diastolic dysfunction are probably associated with T-cell disbalance and an increase in intermediate monocyte counts.
（1）背景：慢性炎症和纤维化是与左心室肥厚（LVH）及射血分数保留的心力衰竭（HFpEF）相关的心脏重塑的关键因素。单核细胞和辅助性T细胞（Th）参与促炎和纤维化过程，而调节性T细胞（Treg）可被认为能抑制肥厚心肌中的慢性炎症。我们旨在评估根据HFpEF的存在情况，LVH患者循环CD4 T细胞和单核细胞亚群频率与左心室（LV）舒张功能变量之间的关系。（2）方法：我们纳入了57例无症状高血压LVH患者（n = 21）或与HFpEF相关的LVH患者（n = 36）。分析了临床评估和超声心动图。通过直接免疫荧光和流式细胞术评估CD4 Treg、活化的Th（Th-act）和单核细胞（经典、中间和非经典）亚群。（3）结果：HFpEF患者的Treg/Th-act比值较低（P = 0.001）。尽管无症状患者和HFpEF患者在总单核细胞数量和单核细胞亚群方面具有可比性，但在HFpEF患者中，中间单核细胞计数与LV舒张功能障碍的传统和新型超声心动图变量之间存在中度相关性。（4）结论：在LVH患者中，临床恶化（转变为HFpEF）和LV舒张功能障碍的进展可能与T细胞失衡和中间单核细胞计数增加有关。
