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Association between serum total antioxidant status and coronary microvascular function in idiopathic dilated cardiomyopathy

Zusammenhang zwischen Gesamtantioxidanzienstatus im Serum und mikrovaskulärer koronarer Funktion bei idiopathischer dilatativer Kardiomyopathie

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Abstract

Background

Coronary microvascular impairment may cause myocardial ischemia and systolic dysfunction in patients with idiopathic dilated cardiomyopathy (IDC).

Patients and methods

The study included 41 patients with IDC and 33 healthy control subjects. Serum total antioxidant status (TAS), serum interleukin (IL)-6 levels, and tumor necrosis factor (TNF)-α levels were assayed and coronary flow reserve (CFR) was measured in all subjects via echocardiography.

Results

High-sensitivity C-reactive protein (hsCRP) levels were significantly higher in patients with IDC than in the control group (3.42 ± 2.14 vs. 1.91± 1.40, p = 0.001). Serum TAS was statistically lower in patients with IDC than in controls (1.23 ± 0.16 vs. 1.77 ± 0.12, p < 0.001). CFR was statistically and significantly lower in the IDC group (2.10 ± 0.39 vs. 3.09 ± 0.49, p < 0.001). The IDC group was subsequently subdivided into two groups according to CFR values, as CFR ≥ 2 and CFR < 2. HsCRP (4.30 ± 2.42 vs. 2.58 ± 1.42, p = 0.01), TNF-α (16.67 ± 8.08 vs. 10.97 ± 1.63, p = 0.01), and IL-6 (7.54 ± 6.16 vs. 3.14 ± 1.10, p = 0.05) values were significantly higher in the CFR < 2 group compared with the higher CFR group. TAS (1.3 ± 0.16 vs. 1.14 ± 0.10, p < 0.001) was significantly lower in the CFR < 2 group. CFR correlated significantly with hsCRP, TAS, red cell distribution width (RDW), IL-6, and TNF-α.

Conclusion

Plasma proinflammatory cytokine levels are increased in patients with IDC. CFR was impaired as a reflection of impaired coronary microvascular dysfunction in association with increasing plasma proinflammatory cytokine levels and hsCRP levels.

Zusammenfassung

Hintergrund

Eine Störung der koronaren Mikrozirkulation kann bei Patienten mit idiopathischer dilatativer Kardiomyopathie (IDC) zur Myokardischämie und systolischen Dysfunktion führen.

Patienten und methoden

In die Studie aufgenommen wurden 41 Patienten mit IDC und 33 gesunde Kontrollen. Bei allen Teilnehmern wurden Gesamtantioxidanzienstatus („total antioxidant status“, TAS) im Serum, Interleukin(IL)-6 im Serum und Tumornekrosefaktor(TNF)-alpha-Wert bestimmt sowie die koronare Flussreserve (CFR) mittels Echokardiographie ermittelt.

Ergebnisse

Bei den Patienten mit IDC waren die Werte für hochsensitives C-reaktives Protein (hsCRP) signifikant höher als in der Kontrollgruppe (3,42 ± 2,14 vs. 1,91± 1,40; p = 0,001). Der Serum-TAS war bei IDC-Patienten statistisch niedriger als bei den Kontrollen (1,23 ± 0,16 vs. 1,77 ± 0,12; p < 0,001). Statistisch signifikant vermindert war die CFR in der IDC-Gruppe (2,10 ± 0,39 vs. 3,09 ± 0,49; p < 0,001).

Die IDC-Gruppe wurde entsprechend ihrer CFR in 2 Gruppen unterteilt, CFR ≥ 2 und CFR < 2. Die Werte für HsCRP (4,30 ± 2,42 vs. 2,58 ± 1,42; p = 0,01), TNF-α (16,67 ± 8,08 vs. 10,97 ± 1,63; p = 0,01) und IL-6 (7,54 ± 6,16 vs. 3,14 ± 1,10; p = 0,05) waren in der Gruppe mit einer CFR < 2 signifikant höher als in der Gruppe mit einer höheren CRF. Der TAS (1,3 ± 0,16 vs. 1,14 ± 0,10; p < 0,001) war in der Gruppe mit einer CFR < 2 signifikant niedriger. Die CFR korrelierte signifikant mit hsCRP, TAS, Erythrozytenverteilungsbreite (RDW), IL-6 und TNF-α.

Schlussfolgerung

Bei Patienten mit IDC sind die Werte für proinflammatorische Zytokine im Plasma erhöht. Dabei war als Zeichen einer gestörten koronaren Mikrozirkulation in Zusammenhang mit erhöhten Werten für proinflammatorische Zytokine und hsCRP im Plasma die CFR beeinträchtigt.

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Compliance with ethical guidelines

Conflict of interest. M. Caliskan, H. Gullu, D. Erdogan, M. Ozulku, S. Kulaksızoglu, O. Ciftci, and H. Muderrisoglu state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Department of Cardiology , Baskent University, Adana Teaching and Medical Research Center, Adana, Turkey

    H. Gullu

  2. Department of Cardiology, Baskent University, Konya Teaching and Medical Research Center, Hoca Cihan Mah., Saray Cad., No:1, Selcuklu, Konya, Turkey

    M. Caliskan MD, D. Erdogan, O. Ciftci & H. Muderrisoglu

  3. Department of Cardiovascular Surgery, Baskent University, Konya Teaching and Medical Research Center, Konya, Turkey

    M. Ozulku

  4. Department of Biochemistry, Baskent University, Konya Teaching and Medical Research Center, Konya, Turkey

    S. Kulaksızoglu

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  1. M. Caliskan MD
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  2. H. Gullu
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Correspondence to M. Caliskan MD.

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Caliskan, M., Gullu, H., Erdogan, D. et al. Association between serum total antioxidant status and coronary microvascular function in idiopathic dilated cardiomyopathy. Herz 40, 487–494 (2015). https://doi.org/10.1007/s00059-013-4021-x

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  • DOI: https://doi.org/10.1007/s00059-013-4021-x

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