Cardiologia Croatica, Vol. 13 No. 7-8, 2018.
Original scientific paper
https://doi.org/10.15836/ccar2018.223
Inflammatory Mediators and Their Association with Diastolic Dysfunction and Heart Remodeling in the Elderly
Lidija Veterovska Miljković
; The Public Health Institution: Gerontology Institute “13 November”, Skopje, Republic of Macedonia
Lidija Pavleska
; The Public Health Institution: Gerontology Institute “13 November”, Skopje, Republic of Macedonia
Biljana Petreska Zović
; The Public Health Institution: Gerontology Institute “13 November”, Skopje, Republic of Macedonia
Abstract
Introduction: The most important index for heart remodeling in old age, besides left ventricular hypertrophy and left atrium dilatation, also represents the progressive left ventricular diastolic dysfunction,
which seems to be the most important marker for cardiac aging.
Aim: To prove the association and the role of systemic inflammation present in the most frequent comorbid diseases in old age (arterial
hypertension, diabetes mellitus, obesity, and chronic renal dysfunction) with the existence of diastolic dysfunction in heart failure with preserved ejection fraction in the elderly. To establish the level of inflammatory
mediators: IL-6 and hs-CRP in the blood of patients in the test and control group and to correlate this with echocardiographic parameters for diastolic dysfunction as well as with the level of carotid
atheromathosis.
Patients and Methods: A total of 78 patients aged >65 years were investigated; cardiac failure with preserved ejection fraction was found in 60 using clinical and echocardiographic tests, as well as the presence of one or several investigated comorbidities, while 18 patients were relatively healthy elderly persons without comorbidities. All patients underwent clinical investigations, electrocardiography, laboratory analyses, echocardiography, and carotid Doppler sonography.
Results: Patients with heart failure with preserved ejection fraction had abnormalities of the heart and vascular structure, compared with the relatively healthy group of the elderly. These patients had more significant heart remodeling (concentric left-ventricular hypertrophy and left atrial dilatation), as well as diastolic dysfunction (higher E/e’, lower e’), and abnormal vascular dysfunction (changes in carotid blood vessels). The serum level of IL-6 and hs-CRP showed significant association with the parameters of diastolic dysfunction, as well as
with the level of the left vascular hypertrophy, the parameters of the eft atrial remodeling, the level of the heart failure (NYHA), and carotid atheromatosis.
Conclusion: Inflammation and oxidative stress, in addition to being the most common comorbidities in elderly, have a role in developing diastolic dysfunction, heart remodeling, and the appearance of heart failure with preserved ejection fraction.
Keywords
inflammatory mediators; diastolic dysfunction; heart failure
Hrčak ID:
203984
URI
Publication date:
23.7.2018.
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