Hill Publishing Group | contact@hillpublisher.com

Hill Publishing Group

Location:Home / Journals / International Journal of Clinical and Experimental Medicine Research /

DOI:http://dx.doi.org/10.26855/ijcemr.2022.10.001

Systemic Inflammation Caused by Comorbidietes and Echocardiografically Established Diastolic Dysfunction in Heart Failure with Preserved Ejecion Fraction in the Elderly

Date: August 8,2022 |Hits: 357 Download PDF How to cite this paper

Lidija Veterovska Miljkovic

Specialized Hospital for Geriatric and Palliative Medicine “13 November”, Skopje, North Macedonia.

*Corresponding author: Lidija Veterovska Miljkovic

Abstract

Introduction: The treatment of chronic heart failure reached significant progress within the last decades. However, the progress is mainly limited only to patients with reduced ejection fraction, and recently to those with medially reduced ejection fraction, while the heart failure with preserved ejection fraction (HFpEF) remains enigma even beside significant morbidity and mortality. One of suggested hypotheses is, that comorbidities cause systemic inflammation, coronary microvascular dysfunction and oxidative stress, which lead to myocardial fibrosis, stiffness of myocytes and, at the end to diastole dysfunction (DD) and HFpEF. Material and methods: Clinically prospective average study, which included 124 patients, aged above 65 years, out of which 85 patients were in the investigated group, which completed the criteria for existence of HFpEF and present comorbidities, and 39 patients—control group. Results: The values of the investigated inflammation mediators highly sensitive (hs - CRP) and interleukin - 6 (IL-6) from peripheral blood, significantly differed among the old individuals with HFpEF and comorbidities, compared to the control group. However, the applied statistical methods mostly showed a direct correlation of inflammation mediators with the parameters of DD and heart remodelling, which has been characteristic for HFpEF. Conclusion: Our investigation went in favor to the hypothesis that the chronic, with low degree - inflammation, present in the most frequent comorbidities in the old age, brought to increased atheromatosis, DD and heart remodelling, being characteristic for HFpEF in old people.

References

[1] Jenny, N. S., French, B., Arnold, A. M., Strotmeyer, E. S., Cushman, M., Chaves, P. H. (2012). Long-term assessment of inflammation and healthaging in late life: the Cardiovascular Health Study All Stars. J Gerontol A Biol Sci Med Sci., 2012 Sep, 67(9): 970-6. doi: 10.1093/gerona/glr261. Epub 2012 Feb. 

[2] Gomez, C. R., Boehmer, E. D., Kovacs, E. J. (2005). The aging innate immune system. Curr Opin Immunol., 2005, 17: 457.

[3] Fernández-Ballesteros, R., Marie Robine, J., Walker, A., and Kalache, A. Active Aging: A Global goal. Hindawi. https://doi.org/10.1155/2013/298012.

[4] Cevenini, E., Monti, D., Franceschi, C. (2013). Inflamm-ageing. Curr Opin Clin Nutr Metab Care, 2013, 16: 14-20. doi: 10.1097/MCO.0b013e32835ada13.

[5] Minciullo, P. L., Catalano, A., Mandraffino, G., Casciaro, M., Crucitti, A., Maltese, G., et al. (2016). Inflammaging and anti-inflammaging: the role of cytokines in extreme longevity. Arch Immunol Ther Exp (Warsz), 2016, 64: 111-26. doi: 10.1007/s00005-015-0377-3.

[6] Mohammed, S. F., Borlaug, B. A., Roger, V. L., Mirzoyev, S. A., Rodeheffer, R. J. (2012). Comorbidity and ventricular and vascular structure and function in heart failure with preserved ejection fraction: a community-based study. Circ Heart Fail, 2012 Nov, 5(6): 710-9. doi: :10.1161/CIRCHEARTFAILURE.112.968594.

[7] Little, W. C., Zile, M. R. (2012). HFpEF: Cardiovascular abnormalities not just comorbidities. Circ Heart Fail, 2012, 5: 6696-6671.

[8] Lopez-Candales, А., Hernández Burgos, P., Hernandez-Suarez, D. (2017). Linking Chronic Inflammation with Cardiovascular Disease: From Normal Aging to the Metabolic Syndrome. J Nat Sci., 2017 Apr, 3(4): e341. doi.org/10.1016/j.jfma.2017.02.002.

[9] Guarner, V., Esther Rubio-Ruiz, M. (2014). Low-Grade Systemic Inflammation Connects Aging, Metabolic Syndrome and Cardiovascular Disease. Interdiscipl Top Gerontol. Basel, Karger, 2014, vol. 40, pp. 99-106. DOI: 10.1159/000364934. 

[10] Fang, L., Ellims, A. H., Beale, A. L., Taylor, A. J., Murphy, A., Dart, A. M. (2017). Systemic inflammation is associated with myocardial fibrosis, diastolic dysfunction, and cardiac hypertrophy in patients with hypertrophic cardiomyopathy. Am J Transl Res., 2017 Nov 15, 9(11): 5063-5073. Collection 2017.

[11] Apovian, C. M., Gokce, N. (2012). Obesity and cardiovascular disease. Circulation, 2012, 125: 1178-82 doi: 10.1161/CIRCULATIONAHA.111.022541.

[12] N. R. S. Pivetta, J. C. S. Marincolo, A. L. Neri, I. Aprahamian, M. S. Yassuda. (2019). Multimorbidity, frailty and functional disability in octogenarians: A structural equation analysis of relationship. https://doi.org/10.1016/j.archger.2019.

[13] Phan, T. T. and Frenneaux, M. (2010). The pathophysiology of diastolic heart failure. Biology reports, 2010, 2; 16-20, Feb 24. doi: 10.3410/B2-16. 

[14] Paulus, J. W., Tschöpe, C. (2013). A Novel Paradigm for Heart Failure With Preserved Ejection Fraction: Comorbidities Drive Myocardial Dysfunction and Remodeling Through Coronary Microvascular Endothelial Inflammation. doi.org/10.1016/j.jacc.2013.02.092.

[15] Lam, C. S., Roger, V. L., Roden Heffer, R. J., et al. (2007). Cardiac structure and ventricular-vascular function in persons with heart failure and preserved ejection fraction from Olmsted Country, Minnesota, Circulation, 2007, 115: 1982-990.

[16] Edelmann, F., at al. (2011). Contribution of comorbidities to functional impairment is higher in heart failure with preserved than with reduced ejection fraction. Clinical Research in cardiology, 100, 755-764/2011.

[17] Streng, K. W., Nauta, J., et al. (2016). Non- cardiac comorbidities in heart failure with reduced, mid-range and preserved ejection fraction. https//doi.org/10.2016.

[18] Zoppini, G., et al. (2018). The E/e' ratio difference between subjects with type 2 diabetes and controls. A meta-analysis of clinical studies. PLoS One, 2018.

[19] Masiha, S., Sundström, J., Lind, L. (2013). Inflammatory markers are associated with left ventricular hypertrophy and diastolic dysfunction in a population-based sample of elderly men and women. J Hum Hypertens, 2013 Jan, 27(1): 13-7. https://doi.org/10.1038/jhh.2011.113. 

[20] Ueland, L., Vinge, T., Elif, E., Finsen, A., Aukrust, P. (2012). Inflammatory Cytokines in Heart Failure: Mediators and Markers. Cardiology, 2012, 122: 23-35.

[21] Giovannini, S., Onder, G., Liperoti, R., Russo, A., Carter, C., Capoluongo, E., et al. (2011). Interleukin-6, C-reactive protein, and tumor necrosis factor-α as predictors of mortality in frail, community-living elderly individuals. J Am Geriatr Soc., 2011, 59: 1679-85. doi: 10.1111/j.1532-5415.

[22] Cesari, M., Onder, G., Zamboni, V., Capoluongo, E., Russo, A., Bernabei, R., et al. (2009). C-reactive protein and lipid parameters in older persons aged 80 years and older. J Nutr Health Aging, 2009, 13: 587-93. doi: 10.1007/s12603-009-0168-9.

[23] Ozuğuz, U., Ergün, G., Işık, S., Gökay, F., Tütüncü, Y., Akbaba, G., Berker, D., Güler, S. Association between C-reactive protein, carotid intima-media thickness and P-wave dispersion in obese premenopausal women: an observational study. Original Investigation Özgün Araşt›rma.

[24] Meléndez, G. C., McLarty, J. L., Levick, S. P., Du, Y., Janicki, J. S., Brower, G. L. (2010). Interleukin 6 mediates myocardial fibrosis, concentric hypertrophy, and diastolic dysfunction in rats. Hypertension, 2010 Aug, 56(2): 225-31. doi: 10.1161/HYPERTENSIONAHA.109.148635. Epub 2010 Jul 6.

[25] Dinh, W., Füth, R., Nickl, W., Krahn, T., Ellinghaus, P., Scheffold, T., et al. (2009). Elevated plasma levels of TNF-alpha and interleukin-6 in patients with diastolic dysfunction and glucose metabolism disorders. Cardiovasc Diabetol, 2009 Nov 12, 8: 58. https://doi.org/10.1186/1475-2840-8-58. 

[26] Tang, Y., Fung, E., Xu, A., Lan, H. Y. (2017). C-reactive protein and ageing. Clin Exp Pharmacol Physiol., 2017 Dec, 44 Suppl 1: 9-14. doi: 10.1111/1440-1681.12758.

[27] Ahmadi-Abhari, S., Luben, R. N., Wareham, N. J., Khaw, K. T. (2013). Distribution and determinants of C-reactive protein in the older adult population: European Prospective Investigation into Cancer-Norfolk study. Eur J Clin Invest., 2013, 43: 899-911. doi: 10.1111/eci.12116.

[28] Abhayaratna, W. P., Marwick, T. H., Smith, W. T., Becker, N. G. (2006). Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey. Heart, 2006, 92: 1259-64.

[29] Gottdiener, J. S., Kitzman, D. W., Aurigemma, G. P., et al. (2006). Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons > 65 years of age (the cardiovascular health study). Am J Cardiol, 2006, 97: 83-9.

[30] Cioffi, G., Mureddu, G. F., Stefenelli, C. (2006). Infuence of age on the relationship between left atrial performance and left ventricular systolic function in systemic arterial hypertension. Exp Clin Cardiol., 2006, 11: 305-10.

[31] Hristovski, Z., Zafirovska, P., Projevska-Donegati, D., Georgievska-Ismailj, L. J. (2013). Assesment of diastolic dysfunction in patients with diabetic cardiomyopathy and preserved systolic left ventricular function. Physioacta, 2013, 7: 9-22.

[32] Veterovska Miljkovic, L., Spiroska, V. (2015). Heart Failure with Preserved Ejection Fraction- Concept, pathophisiology, Diagnosis and Challenges for Treatment. Open Access Macedonian Journal of Medical Sciences, 2015: 3(3): 521-527.

[33] Deepak Y. Kamath, Denis Xavier, Alben Sigamani. (2015). High sensitivity C-reactive protein (hsCRP) & cardiovascular disease: An Indian perspective. Indian J Med Res., 2015 Sep, 142(3): 261-268. doi: 10.4103/0971-5916.166582.

[34] Windgassen, E. B., Funtowicz, L., Lunsford, T. N., Harris, L. A., Mulvagh, S. L. (2011). C-Reactive Protein and High-Sensitivity C-Reactive protein: an Update for Clinicians. Postgrad Med., 2011 Jan, 123(1): 114-9.

[35] Vaucher, J., Marques-Vidal, P., Waeber, G., Vollenweider, P. (2014). Cytokines and hs-CRP levels in individuals treated with low-dose aspirin for cardiovascular prevention: a population-based study (CoLaus Study). Cytokine, 2014, 66: 95-100. doi: 10.1016/j.cyto.2014.01.003.

[36] Franceschi, C., Capri, M., Monti, D., et al. (2007). Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev., 2007, 128(1): 92-105.

[37] Nadrowski, P., Chudek, J., Skrzypek, M., Puzianowska-Kuźnicka, M., Mossakowska, M., Więcek, A., et al. (2016). Associa-tions between cardiovascular disease risk factors and IL-6 and hsCRP levels in the elderly. Exp Gerontol, 2016 Dec 1, 85: 112-117. https://doi.org/10.1016/j.exger.2016.10.001.

[38] Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., et al. (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr, 2015 Jan, 28(1): 1-39.e14. https://doi.org/ 10.1016/ j.echo.2014.10.003.

[39] Nagueh, S. F., Smiseth, O. A., Appleton, C. P., Byrd, B. F. 3rd, Dokainish, H., Edvardsen, T., et al.; Houston, Texas; Oslo, Norway; Phoenix, Arizona; Nashville, Tennessee; Hamilton, Ontario, Canada; Uppsala, Sweden, et al. (2016). Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur HeartJCardiovascImaging, 2016 Dec, 17(12): 1321-1360. https://doi.org/10.1093/ehjci/jew082.

[40] Ridker, P. From CRP to IL-6 to IL-1: Moving Upstream To Identify Novel Targets for Atheroprotection. doi: 10.1161/CIRCRESAHA.115.306656.

How to cite this paper

Systemic Inflammation Caused by Comorbidietes and Echocardiografically Established Diastolic Dysfunction in Heart Failure with Preserved Ejecion Fraction in the Elderly

How to cite this paper: Lidija Veterovska Miljkovic. (2022) Systemic Inflammation Caused by Comorbidietes and Echocardiografically Established Diastolic Dysfunction in Heart Failure with Preserved Ejecion Fraction in the Elderly. International Journal of Clinical and Experimental Medicine Research6(4), 321-329.

DOI: http://dx.doi.org/10.26855/ijcemr.2022.10.001

Volumes & Issues

Free HPG Newsletters

Add your e-mail address to receive free newsletters from Hill Publishing Group.

Contact us

Hill Publishing Group

8825 53rd Ave

Elmhurst, NY 11373, USA

E-mail: contact@hillpublisher.com

Copyright © 2019 Hill Publishing Group Inc. All Rights Reserved.