Abstract
Relevance. Cardiotrophin-1 (CT-1) is a member of interleukin-6 (IL-6) superfamily and is associated with cardiovascular pathology. The production of CT-1 increases in response to myocardial wall stretching and increase in its rigidity and is also modulated by a wide range of neurohormones and peptides, which allows to monitor CT-1 as a marker of biomechanical stress. However, the prognostic significance of CT-1 in patients with diastolic heart failure with hypertrophic cardiomyopathy (HCM) remains poorly understood.Objective. To study the blood serum cardiotrophin-1 contents and their relationships with NT-proBNP in patients with obstructive hypertrophic cardiomyopathy and in patients with severe left ventricular (LV) dysfunction.Material and Methods. The study comprised a total of 76 patients with obstructive HCM and 31 patients with severe LV dysfunction. The group of patients with HCM comprised patients with obstructive form; the group of patients with severe LV dysfunction included patients with the third type of post-infarction LV remodeling and ejection fraction (EF) of less than 30%. The determination of cardiotrophin-1 and highly sensitive C-reactive protein was carried out by the enzyme immunoassay. The study of NT-proBNP content in blood serum was performed by multiplex immunoassay using the FLEXMAP 3D Luminex Corporation system.Results. The content of cardiotrophin-1 in the blood serum of patients with obstructive HCM was higher than in the group of patients with severe LV dysfunction. The study of NT-proBNP concentrations in the blood serum showed increases in the content in both groups of patients. The median concentrations of NT-proBNP and C-reactive protein in patients with severe LV dysfunction were increased compared to the median concentration in patients with obstructive HCM.Conclusion. The study showed an increase in cardiotrophin-1 content in the blood serum in patients with obstructive HCM with chronic diastolic heart failure. The increase in cardiotrophin-1 content was directly associated with the increase in NTproBNP level in patients with obstructive HCM with chronic diastolic heart failure.
Highlights
Informed consent was obtained from all patients
The study was approved by the Ethics Committee of Cardiology Research Institute of Tomsk NRMC
Повышение содержания СТ-1 у больных обструктивной гипертрофической кардиомиопатии (ГКМП) с хронической диастолической сердечной недостаточностью (СН) прямо взаимосвязано с увеличением уровня NT-proBNP
Summary
Анализ выполнен у 76 больных обструктивной ГКМП в возрасте 48,84 ± 14,83 лет и у 31 пациента с тяжелой левожелудочковой дисфункцией (ЛЖД) в возрасте 55,44 ± 11,97 лет. Группу пациентов с ГКМП составили больные обструктивной формой с пиковым градиентом в выводном отделе (ВО) ЛЖ – 75,5 ± 29,0 мм рт. В группу пациентов с тяжелой ЛЖД вошли больные с третьим типом постинфарктного ремоделирования ЛЖ [12] и ФВ менее 30%. Образцы крови брали на этапе включения пациентов в исследование. Что у больных обструктивной ГКМП содержание СТ-1 в сыворотке крови выше, чем в группе пациентов с тяжелой ЛЖД. Для определения СН оценивали содержание NT-proBNP, было выявлено изменение содержания NT-proBNP в сыворотке крови у всех пациентов, включенных в исследование, значения превышали патологически значимый уровень 125 пг/мл (таблица). Медиана концентрации NT-proBNP у пациентов с обструктивной ГКМП была снижена по сравнению с пациентами с тяжелой ЛЖД.
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