Interleukin-6 is independently associated with right ventricular function in pulmonary arterial hypertension.
Interleukin-6 is independently associated with right ventricular function in pulmonary arterial hypertension.
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DOI：
10.1016/j.healun.2017.08.011
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Thenappan T
中科院分区：
文献类型：
--
作者：
Prins KW;Archer SL;Pritzker M;Rose L;Weir EK;Sharma A;Thenappan T
肺动脉高压（PAH）患者血清白细胞介素6（IL-6）水平升高会导致更大的症状负担和更高的死亡率；然而，这些观察结果背后的机制仍不清楚。由于临床前和临床数据均表明 IL-6 水平升高与心功能受损有关，因此我们推测 IL-6 在 PAH 中的不良反应部分是由右心室 (RV) 功能障碍造成的。我们分析了我们机构 PAH 登记处确定的 40 名 PAH 患者的 IL-6 和 RV 功能之间的关系。通过酶联免疫测定法对血清IL-6水平进行定量。 PAH 患者的 IL-6 水平高于年龄和性别匹配的对照组。循环 IL-6 水平与基于超声心动图的 RV 功能和 RV-肺动脉 (RV-PA) 耦合测量值呈负相关。将 PAH 患者除以中位 IL-6 水平时，IL-6 较高的患者的 RV 功能显着较差（面积变化分数 [FAC] 23 ± 12% vs 38 ± 11%，三尖瓣环平面收缩期偏移 [TAPSE] 1.3 ± 0.3 cm vs 2.1 ± 0.5 cm），RV-PA 耦合受损（0.6 ± 0.5%/mm Hg vs 0.9） ± 0.5%/mm Hg）、较高的右心房压力（13 ± 7 mm Hg vs 9 ± 5 mm Hg）、心脏指数降低（2.0 ± 0.5 升/分钟/m2 vs 2.8 ± 1.0 升/分钟/m2）以及较低的每搏输出量（48 ± 20 ml vs 70 ± 28 ml）。相反，IL-6与平均肺动脉压（mPAP）、肺血管阻力（PVR）和肺动脉顺应性（PAC）之间的关系不显着。最后，在调整 RV 上的静态 (PVR) 和脉动 (PAC) 后负荷后，IL-6 与 RV 功能和 RV-PA 耦合独立相关。血清 IL-6 水平与 PAH 中的 RV 功能和 RV-PA 偶联独立相关。尽管肺血管疾病的严重程度相当，但 IL-6 水平较高的患者具有更严重的 RV 功能障碍和 RV-PA 耦合减弱。
An elevated serum level of interleukin-6 (IL-6) in pulmonary arterial hypertension (PAH) patients results in a greater symptom burden and increased mortality; however, the mechanisms underlying these observations remain unclear. Because both pre-clinical and clinical data associate elevated IL-6 levels with impaired cardiac function, we hypothesized that the adverse effects of IL-6 in PAH result, in part, from right ventricular (RV) dysfunction. We analyzed the relationship between IL-6 and RV function in 40 patients with PAH identified in our institutional PAH registry. Serum IL-6 levels was quantified by enzyme-linked immunoassay. PAH patients had higher IL-6 levels than age- and gender-matched controls. Circulating IL-6 levels correlated inversely with echocardiography-based measures of RV function and RV–pulmonary artery (RV-PA) coupling. When dividing PAH patients by median IL-6 level, patients with higher IL-6 had significantly worse RV function (fractional area change [FAC] 23 ± 12% vs 38 ± 11%, tricuspid annular plane systolic excursion [TAPSE] 1.3 ± 0.3 cm vs 2.1 ± 0.5 cm), impaired RV-PA coupling (0.6 ± 0.5%/mm Hg vs 0.9 ± 0.5%/mm Hg), higher right atrial pressure (13 ± 7 mm Hg vs 9 ± 5 mm Hg), reduced cardiac index (2.0 ± 0.5 liters/min/m2 vs 2.8 ± 1.0 liters/min/m2) and lower stroke volume (48 ± 20 ml vs 70 ± 28 ml). In contrast, the relationships between IL-6 and mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR) and pulmonary arterial compliance (PAC) were not significant. Finally, IL-6 was independently associated with RV function and RV-PA coupling after adjusting for static (PVR) and pulsatile (PAC) after-load on the RV. Serum IL-6 levels are independently associated with RV function and RV-PA coupling in PAH. Patients with higher IL-6 levels have more severe RV dysfunction and diminished RV-PA coupling despite a comparable severity of pulmonary vascular disease.
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DOI：
10.1016/j.jss.2012.04.066
发表时间：
2012-12
期刊：
The Journal of surgical research
影响因子：
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作者：
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