Relationship between tumor necrosis factor alpha and interleukin-10 and left ventricular remodeling in renal failure
I.T. Murkamilov, I.S. Sabirov, V.V. Fomin, Zh.A. Murkamilova, I.O. Kudaibergenova, F.A. Yusupov
1) I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan;
2) Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan;
3) Sechenov University Moscow, Russia;
4) Osh State University, Osh, Kyrgyzstan
Objective. Evaluation of the relationship between the cytokine profile and the type of left ventricular hypertrophy in renal failure.
Material and methods. 55 patients with renal failure (RF) and left ventricular hypertrophy (LVH) aged 24 to 79 years, mean age 52.7±13.3 years, 36 men (65.4%), 19 women (34.6%), were examined. All patients underwent clinical, echocardiographic and laboratory examination. The blood tumor necrosis factor alpha (TNF-α), interleukin (IL)-10, cystatin C, creatinine, electrolytes, C-reactive protein and uric acid levels, as well as the blood lipids were determined. The glomerular filtration rate (GFR) was calculated based on cystatin C and blood creatinine. Depending on the LVH types, patients were divided into two subgroups: concentric (n=20) and eccentric LVH (n=35) with RF.
Results. In the subgroup of patients with eccentric LVH and RF, the mean values of body mass index (30.4±5.2 versus 28.1±5.7 kg/m2; р=0.013), left ventricle end-diastolic diameter (5.37±0.80 versus 4.96±0.52 cm; р=0.044), and the end diastolic volume (134.4±27.1 versus 116.3±26.4 ml; р=0.038) were significantly higher than subgroup with concentric LVH and RF. A significant increase in the interventricular septum (IVS) thickness (1.23±0.20 versus 0.94±0.14 cm; р=0.005), the left ventricular posterior wall (LVPW) thickness (1.22±0.19 versus 0.93±0.13 cm; р=0.005) and relative wall thickness (RWT) (0.50±0.07 versus 0.35±0.04 U; р =0.005) were observed in patients with concentric LVH and RF. A statistically significant direct correlation between the TNF-alpha level and the LV myocardium mass index was recorded (r=0.356; р=0.010), LVPW thickness (r=0.401; р=0.011) and RWT (r=0.325; р=0.045).
Conclusion. In patients with renal failure and eccentric LVH, an increase in body mass index, left ventricle end-diastolic diameter and end diastolic volume was recorded. Meanwhile, in individuals with concentric LVH and RF, there was an increase in the interventricular septum thickness, LV posterior wall thickness, and the relative wall thickness. An increase in LV myocardial mass index was associated with an increase in TNF-alpha level, and an increase in LV wall thickness – with increase in IL-10 level.
Keywords: cytokines, left ventricular hypertrophy, renal failure, cardiovascular complications
About the Autors
I.T. Murkamilov – Cand. Sci. (Med.), Deputy Associate Professor at the Department of Faculty Therapy, I.K. Akhunbaev KSMA; Senior Lecturer of the Department of Therapy №2 in the specialty “General Medicine”, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan; e-mail: email@example.com; ORCID: org/0000-0001-8513-9279
I.S. Sabirov – Dr. Sci. (Med.), Professor, Head of the Department of Therapy №2 in the specialty “General Medicine”, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan; e-mail: firstname.lastname@example.org; ORCID: 0000-0002-8387-5800
V.V. Fomin – Dr. Sci. (Med.)., Professor, Corresponding Member of RAS, Head of the Department of Faculty Therapy №1, N.F. Sklifosovsky Institute of Clinical Medicine,
Vice-Rector for Clinical Work and Postgraduate Professional Education, Sechenov University MSMU, Moscow, Russia;
e-mail: email@example.com; ORCID: org / 0000-0002-2682-4417
Zh.A. Murkamilova – Correspondence Post-Graduate Student at the Department of Therapy № 2 in the specialty “General Medicine”, Kyrgyz-Russian Slavic University, Bishkek; e-mail: firstname.lastname@example.org; ORCID: org / 0000-0002-7653-0433
I.O. Kudaibergenova – Dr. Sci. (Med.), Professor, Rector of the I.K. Akhunbaev KSMA, Bishkek; e-mail: email@example.com; ORCID: org / 0000-0003-3007-8127
F.A. Yusupov – Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Faculty of Medicine, Osh State University;
Chief Neurologist of the Southern Region of Kyrgyzstan, Osh, Kyrgyzstan; e-mail: firstname.lastname@example.org; ORCID: org / 0000-0003-0632-6653