Inflammatory cytokines and their correlations with different left ventricular geometries and functions in PHT patients

作者：Zan, Yu; Wang, Jian^*; Wang, Wenjuan; Cui, Tong; Xu, Kun; Li, Yiying; Huang, Xiaochun; Zhang, Yanjing; Wei, Na; Xing, Xueqing

来源：ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2022, 39(12): 1589-1600.

DOI：10.1111/echo.15495

• automatic two-dimensional speckle-tracking study
• echocardiography
• essential hypertension
• inflammatory cytokines
• left ventricular geometry

Objectives To investigate relationships between hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor -alpha (TNF-alpha), interleukin-17A (IL-17A), and interferon -gamma (IFN-gamma), with left ventricular geometry (LVG) and function in patients with primary hypertension (PHT). Methods A total of 396 PHT patients were assigned into four groups: Normal Geometry (NG), Concentric Remodeling (CR), Eccentric Hypertrophy (EH), and Concentric Hypertrophy (CH). The correlation between hs-CRP, TNF-alpha, IL-17A, IFN-gamma, and clinical, biochemical parameters were analyzed by Pearson correlation analysis and Logistic regression. Receiver Operating Characteristic (ROC) curve was used to analyze the clinical values of hs-CRP, TNF-alpha, IL-17A, and IFN-gamma for abnormal LVG prediction. Results NG, CR, EH, and CH group all presented increasingly higher levels of Hs-CRP, TNF-alpha, IL-17A, and IFN-gamma, and the increase was the most prominent in the CH group. Pearson correlation analysis showed that hs-CRP, IL-17A, and IFN-gamma were all positively correlated with LASct. Hs-CRP, TNF-alpha, and IL-17A were all negatively correlated with GLS, LASr, and LAScd. However, IFN-gamma was only negatively correlated with GLS and LAScd. Logistic regression analysis showed that hs-CRP and IL-17A were independently correlated with CR; hs-CRP, TNF-alpha, IFN-gamma, and IL-17A were independently correlated with EH and CH. ROC curve analysis showed that the area under the curve (AUC) of hs-CRP was 0.816. When the optimal diagnostic threshold of hs-CRP was 3.04 mg/L, the sensitivity and specificity of the abnormal LVG were 72.1% and 81.5%, respectively. Conclusion In PHT patients, hs-CRP, TNF-alpha, IL-17A, and IFN-gamma were correlated with abnormal LVG and left ventricular function, suggesting that inflammatory cytokines may be involved in the process of PHT-induced abnormal left ventricular structure and function. In addition, hs-CRP can be used as a health screening index for patients at high risk of abnormal LVG.

• 单位
  1; 南方医科大学