Interleukins 33 and 1β, left ventricular geometry and diastolic dysfunction in hypertensive patients with obesity

Abstract

Purpose: To investigate interrelations between interleukin 33 (IL-33) and 1β (IL-1β) serum levels, left ventricular (LV) remodeling and diastolic dysfunction (DD) in hypertensive patients with obesity. Materials and methods: 80 hypertensive patients (51 obese) underwent transthoracic echocardiography. LV geometric pattern by A.Ganau, E/A and E/E' ratios, pulmonary wedge pressure (PWP) by S.Nagueh were calculated. IL-33 and IL-1β serum levels were estimated using ELISA. Results: IL-33 and IL-1β were higher in hypertensive patients (p<0,001), independently of BMI, and formed 4 clusters (see pic.) Cluster 1 was associated with the highest LV myocardial mass index (MMI) (160,5 (142,8; 185,8) g/m2, p<0,05), highest prevalence of LV hypertrophy (LVH) (100,0%, 90,0% of concentric LVH), moderate decrease in E' velocity (9,95 (8,32; 10,60) cm/sec), relatively low PWP (9,23 (8,83; 13,03) mmHg) and 70,0% prevalence of LVDD (60,0% of type I). Cluster 2 had LVMMI of (116,9 (104,4; 163,1) g/m2), 55,0% prevalence of LVH plus 30,0% of concentric remodeling, lowest E' (7,68 (6,50; 9,67) cm/sec, p<0,01), highest PWP (12,26 (10,72; 13,12) mmHg, p<0,05) and highest rate of DD (85,0%, 70,0% of type I). Cluster 4 was associated with MMI of 121,4 (111,7; 140,5) g/m2, 66,7% rate of LVH (equal for concentric and eccentric variants), highest values of E' (11,04 (9,49; 12,00) cm/sec), lowest PWP (9,07 (7,04; 11,51) mmHg) and lowest prevalence of LVDD (66,7%, 50,0% of type I). Cluster 3 (p>0,05 vs control group) had intermediate characteristics of mentioned parameters. Conclusion: Significant increase in IL-33 and IL-1β levels in hypertensive patients independently of BMI was revealed. Increase in both cytokines' levels was associated with highest rates of LVH and DD. Prevalent increase in IL-1β was connected to the worst state of diastolic function despite low rates of hypertrophy. Prevalent increase in IL-33 had the most favorable influence on the severity of LVH as well as diastolic filling (figure above).