Elevated plasma levels of TNF-alpha and interleukin-6 in patients with diastolic dysfunction and glucose metabolism disorders.
Elevated plasma levels of TNF-alpha and interleukin-6 in patients with diastolic dysfunction and glucose metabolism disorders.
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DOI：
10.1186/1475-2840-8-58
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发表时间：
2009-11-12
影响因子：
9.3
通讯作者：
Lankisch M
中科院分区：
文献类型：
--
作者：
Dinh W;Füth R;Nickl W;Krahn T;Ellinghaus P;Scheffold T;Bansemir L;Bufe A;Barroso MC;Lankisch M
糖尿病（DM）已达到流行病的比例，是心力衰竭（HF）的重要危险因素。左心室舒张功能障碍（LVDD）被认为是DM引起的LV功能障碍的最早表现，但其病理生理机制仍不完全清楚。我们试图评价稳定性冠状动脉疾病患者促炎细胞因子水平（TNF-α、IL-6）与组织多普勒衍生的LVDD指数之间的关系。我们招募了41名连续患者（平均年龄65+/-10岁）进行冠状动脉造影。对所有患者进行超声心动图评估。在二尖瓣环进行脉冲组织多普勒成像，其特征在于舒张早期舒张速度Em。超声多普勒测量常规二尖瓣血流。测量早期（E）二尖瓣血流速度。E/Em比值≥ 15为LVDD，E/Em 8-14为临界值。测定所有患者的血浆TNF-α和IL-6水平。在无糖尿病的受试者中进行标准化口服葡萄糖耐量试验。与舒张功能正常的患者相比，E/Em比值≥ 15（归类为LVDD）和E/Em比值8-14（归类为临界值）的患者血浆IL-6（P = 0.001）、TNF-α（P <0.001）和NT-pro- BNP（P = 0.001）水平显著升高。经线性回归分析校正性别、年龄、左心室射血功能、体重指数、冠心病、吸烟、高血压和糖尿病后，TNF-α和IL-6水平仍显著升高。此外，在LVDD或临界LV舒张功能的受试者中，75%分别患有糖尿病或IGT。当排除无糖尿病的受试者时，E/Em比≥ 15的受试者中IL-6（P = 0，006）和TNF-alpha（P = 0，002）仍然显着升高。这项研究表明，血浆IL-6和TNF-α水平升高与LVDD相关。这些发现表明轻度炎症与LVDD的存在之间存在联系。一个积极的促炎过程可能是重要的舒张功能障碍的发病机制。
Diabetes mellitus (DM) has reached epidemic proportions and is an important risk factor for heart failure (HF). Left ventricular diastolic dysfunction (LVDD) is recognized as the earliest manifestation of DM-induced LV dysfunction, but its pathophysiology remains incompletely understood. We sought to evaluate the relationship between proinflammatory cytokine levels (TNF-alpha, IL-6) and tissue Doppler derived indices of LVDD in patients with stable coronary artery disease. We enrolled 41 consecutive patients (mean age 65+/-10 years) submitted for coronary angiography. Echocardiographic assessment was performed in all patients. Pulsed tissue Doppler imaging was performed at the mitral annulus and was characterized by the diastolic early relaxation velocity Em. Conventional transmitral flow was measured with pw-doppler. Early (E) transmitral flow velocity was measured. LVDD was defined as E/Em ratio ≥ 15, E/Em 8-14 was classified as borderline. Plasma levels of TNF-alpha and IL-6 were determined in all patients. A standardized oral glucose tolerance test was performed in subjects without diabetes. Patients with E/Em ratio ≥ 15, classified as LVDD and those with E/Em ratio 8-14 (classified as borderline) had significantly higher IL-6 (P = 0,001), TNF-alpha (P < 0,001) and NT-pro- BNP (P = 0,001) plasma levels compared to those with normal diastolic function. TNF-alpha and IL-6 levels remains significantly elevated after adjustment for sex, age, left ventricular ejection function, body mass index, coronary heart disease, smoking, hypertension and diabetes mellitus with linear regression analysis. Furthermore, in subjects LVDD or borderline LV diastolic function, 75% had diabetes or IGT, respectively. When subjects without diabetes were excluded, both IL-6 (P = 0,006) and TNF-alpha (P = 0,002) remained significantly elevated in subjects with E/Em ratio ≥ 15. This study reveals that increased plasma levels of IL-6 and TNF-alpha were associated with LVDD. These findings suggest a link between low-grade inflammation and the presence of LVDD. An active proinflammatory process may be of importance in the pathogenesis of diastolic dysfunction.
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影响因子：
2.8
作者：
From, Aaron M.;Scott, Christopher G.;Chen, Horng H.
通讯作者：
Chen, Horng H.
影响因子：
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DOI：
10.1016/0735-1097(95)00589-7
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1996-04-01
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