Importance of inflammatory cytokines and endothelial peptides in predicting hypertensive left ventricular hypertrophy

ABSTRACT

Although it has been hypothesized that hypertension in part is an inflammatory disorder, the link between inflammation and endothelial disorders with hypertensive complications as left ventricle hypertrophy [LVH] is still marginal. This study was designed to investigate the role of inflammatory markers as interleukin-6 [IL-6], high sensitivity C reactive protein [Hs-CRP], endothelial peptides as endothelin-1 [EDN -1] and nitric oxide [NO] as well as serum lipid profile in predicting LVH. It also focused on the pathophysiological responsibility of inflammation and endothelial dysfunction in developing hypertensive LYH. To examine these hypotheses forty hypertensive patients were enrolled and divided by using echocardiography into hypertensive patients with normal left ventricular mass [Group I] and hypertensive patients with LVH [Group II]. Ten normotensive subjects were also included and considered as control group [C]. ELISA technique was used for measuring plasma concentrations of IL-6, Hs-CRP, EDN-1 by special kits, while serum NO and lipid profile were measured by spectrophotometer. Both hypertensive groups were relatively matched with each other regarding age, gender, body surface area and body mass index [BMI], however they were significantly greater than control. Serum levels of IL-6, Hs-CRP and END-1, were significantly higher and those of NO were significantly lower in both hypertensive groups compared to normotensives. Moreover, these changes were more obvious in hypertensive patients with LVK Additionally, estimation of serum lipid profile showed that levels of total cholesterol triglycerides, and low density lipoproteins [LDL-C] were significantly elevated and that of high density lipoproteins [HDL-C] were significantly reduced in group [II] compared to other groups. Among both hypertensive patients, LY mass index was significantly positively correlated with serum levels of IL-6, Hs-CRP, EDN-1, cholesterol, triglyceride, LDL-C and significantly negatively correlated with HDL-C hut not with age and NO levels. However, the slope of these relations was steeper in the hypertensive group with LVH. Besides, levels of IL-6 and EDN-1 were the most predictors [r= 0.849, P<0.0001, r= 0.889, P<0.0001 respectively] for LYH. The inflammatory markers are significantly increased in hypertensive patients with LVH. Increased EDN-l and lowered NO are also concerned to a greater extent in hypertensive LYH and this confirms a key pathophysiological role of inflammation and endothelium dysfunction in developing and progression of hypertension and LVH which is vital for recommending prophylactic and therapeutic strategies