O.M. Kovalyova, O.V. HoncharInterleukin-33 and left ventricular structural and functional remodeling in hypertensive patients with obesity.

To investigate interrelations between interleukin-33 serum levels and left ventricular structural and functional remodeling in hypertensive patients with obesity. Eighty hypertensive patients (34 male and 46 female) in the age of 59.2±8.2 years have been observed, including 26 patients with the 1st degree of obesity and 27 with the 2nd-3rd degrees. The control group was composed of 10 practically healthy age- and sex-matched persons. Methods of research included echocardiography with transmitral blood flow and lateral mitral annular motion investigation, and interleukins-33 and -1β serum levels investigation using ELISA. Significant increase in both cytokines’ concentrations compared to healthy persons was observed. Cluster analysis revealed peculiarities in both cytokines’ levels distribution that were related to the structural and functional remodeling in observed patients. Left ventricular myocardial mass, myocardial mass index and relative wall thickness were the highest in patients with level of interleukin 33 more than 73 pg/ml and interleukin 1β more than 28 pg/ml (cluster 1) – 311.3 (271.5; 381.0) g, 160.5 (142.8; 185.8) g/m2 and 0.539 (0.484; 0.604) respectively; those patients had the highest rate of concentric hypertrophy (90.0 %), increased ejection fraction (73.5 (67.3; 79.8) %) and high prevalence of type I diastolic dysfunction. Prevalent increase in interleukin-1β level (more than 25 pg/ml with interleukin 33 less than 73 pg/ml, cluster 2) despite relatively low prevalence of left ventricular hypertrophy (55.0 %) was associated with the most significant changes of diastolic filling: early diastolic mitral annular peak velocity (E’) of 7.68 (6.50; 9.67) cm/sec, E/E’ ratio 8,34 (7.11; 9.04), pulmonary wedge pressure 12.26 (10.72; 13.12) mm Hg, and the highest rate of diastolic dysfunction (85.0 %, 70.0 % of type I). Values of interleukin-33 more than 71 pg/ml with interleukin-1β less than 25 pg/ml (cluster 4) were associated with relatively low left ventricular mass and hypertrophy rate (with equal prevalence of concentric and eccentric variants), the highest E’ values (11.04 (9.49; 12.00) cm/sec) and rate of normal diastolic filling (33.3 %), the lowest E/E’ ratio (5.78 (4,14; 7.74)) and pulmonary wedge pressure (9.07 (7.04; 11.51) mm Hg). A significant increase in interleukin-33 and interleukin-1β serum levels in patients with hypertension was observed compared to healthy persons. Prevalent increase in interleukin 1β level was associated with most significant changes of diastolic filling, despite low rates of hypertrophy. On the contrary, prevalent increase in interleukin 33 had a most favorable influence on the severity of left ventricular hypertrophy as well as diastolic filling.

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