TY - JOUR

T1 - Heart Dysfunction in Essential Hypertension Depends on Systemic Proinflammatory Influences

T2 - A Retrospective Clinical Pathophysiological Study

AU - Barsukov, Anton V

AU - Korovin, Alexander E

AU - Churilov, Leonid P

AU - Borisova, Ekaterina V

AU - Tovpeko, Dmitry V

N1 - Publisher Copyright: © 2022 by the authors.

PY - 2022/9

Y1 - 2022/9

N2 - Low-intensity systemic inflammation is an important element of heart failure pathogenesis. The aim of this study is to assess proinflammatory status serum indicators (C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6)) in middle-aged males (M) and females (F) with essential hypertension (HTN) depending on left ventricular (LV) diastolic dysfunction (LVDD). The main group comprised 55 M and 49 F with the first- to second-severity grade HTN with mild heart failure and a preserved LV ejection fraction ≥50%. Patients had sinus rhythm, first or second-severity degree LVDD, LV hypertrophy, left atrium dilatation, and NT-proBNP > 125 pg/mL. Comparison group: 30 hypertensives without cardiac dysfunction; control group: 31 normotensives. Quantitative features were compared using the Mann-Whitney test, median χ2, ANOVA module. Spearman's rank correlation coefficients were determined to identify the relationship between the proinflammatory pattern and exercise tolerance. Hypertensive M had markedly higher CRP, TNF-α, and IL-6 levels compared to F. All mean values corresponded to reference range. In patients with second-degree LVDD, CRP, TNF-α, and IL-6 levels were significantly greater than in subjects with first-degree LVDD (both within M and within F samples). Significant negative associations between CRP, IL-6, and TNF-α levels and the 6 min walk test existed in hypertensive M and F. The study demonstrated a close relationship between the proinflammatory pattern and LVDD and exercise tolerance indicators, regardless of the hypertensive patient's sex.

AB - Low-intensity systemic inflammation is an important element of heart failure pathogenesis. The aim of this study is to assess proinflammatory status serum indicators (C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6)) in middle-aged males (M) and females (F) with essential hypertension (HTN) depending on left ventricular (LV) diastolic dysfunction (LVDD). The main group comprised 55 M and 49 F with the first- to second-severity grade HTN with mild heart failure and a preserved LV ejection fraction ≥50%. Patients had sinus rhythm, first or second-severity degree LVDD, LV hypertrophy, left atrium dilatation, and NT-proBNP > 125 pg/mL. Comparison group: 30 hypertensives without cardiac dysfunction; control group: 31 normotensives. Quantitative features were compared using the Mann-Whitney test, median χ2, ANOVA module. Spearman's rank correlation coefficients were determined to identify the relationship between the proinflammatory pattern and exercise tolerance. Hypertensive M had markedly higher CRP, TNF-α, and IL-6 levels compared to F. All mean values corresponded to reference range. In patients with second-degree LVDD, CRP, TNF-α, and IL-6 levels were significantly greater than in subjects with first-degree LVDD (both within M and within F samples). Significant negative associations between CRP, IL-6, and TNF-α levels and the 6 min walk test existed in hypertensive M and F. The study demonstrated a close relationship between the proinflammatory pattern and LVDD and exercise tolerance indicators, regardless of the hypertensive patient's sex.

KW - 6 min walk test

KW - chronic heart failure

KW - correlation analysis

KW - diastolic dysfunction

KW - essential arterial hypertension

KW - preserved ejection fraction

KW - proinflammatory status

KW - sex differences

UR - https://www.mendeley.com/catalogue/17172825-1ad5-377c-b591-fd9d98ae7b26/

UR - http://www.scopus.com/inward/record.url?scp=85138703272&partnerID=8YFLogxK

U2 - 10.3390/pathophysiology29030036

DO - 10.3390/pathophysiology29030036

M3 - Article

C2 - 35997392

VL - 29

SP - 453

EP - 468

JO - Pathophysiology

JF - Pathophysiology

SN - 0928-4680

IS - 3

ER -