Immunopathological reactions, endothelial dysfunction and pathological angiogenesis as independent mechanisms of maladaptive left ventricular remodeling in ischemic and nonischemic heart failure patients

Authors

  • O. V. Rasputniak SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • T. I. Havrylenko SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv, Ukraine
  • K. V. Rudenko SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • N. O. Ryzhkova SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv, Ukraine
  • O. A. Pidhaina SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv, Ukraine
  • O. V. Rybakova SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • V. P. Zalevskyi SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • О. M. Lomakovskyi SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv, Ukraine

DOI:

https://doi.org/10.14739/2310-1210.2021.2.211951

Keywords:

heart failure, left ventricular remodeling, pathological angiogenesis, TNF-alpha, VEGF, endothelin-1

Abstract

Regardless of the great progress in studying the heart failure (HF) pathophysiology, the question about involvement of immune cells activation, systemic inflammation, inflammatory cytokine dysregulation and endothelial dysfunction in maladaptive left ventricular (LV) remodeling in ischemic and nonischemic HF patients is still open to discussion.

The aim was to study the characteristics of immunopathological reactions (immunoinflammatory and autoimmune), endothelial dysfunction and pathologic angiogenesis in maladaptive LV remodeling in ischemic and nonischemic HF patients.

Materials and methods. A total of 20 healthy volunteers, 31 ischemic HF patients (group 1) and 43 nonischemic HF patients (group 2) were enrolled in the study. All the patients underwent coronarography, ventriculography, echocardigraphic examination. The main lymphocyte subset counts (flow cytometry), serum concentration of C-reactive protein (CRP), vascular endothelial growth factor A (VEGF), TNFα, endothelin-1 (enzyme-linked immunosorbent assay (ELISA)), autoantibodies to myocardium and vessels were detected.

Results. Regardless of the HF etiology, all the examined patients demonstrated echocardiographic features of maladaptive LV remodeling and severe intracardiac hemodynamic disorders that was associated with immune system activation, namely increased total and subset lymphocyte counts, chronic systemic inflammation (CRP), autoimmune process with an increase in autoantibodies to myocardium and vessels, and endothelial dysfunction (increased endothelin-1 and VEGF). Under-expression of TNF-α combined with over-expression of VEGF seemed to indicate pathological angiogenesis in ischemic and nonischemic HF patients

Conclusions. Significantly increased VEGF levels in heart failure patients can be considered as additional integral key marker of immune inflammation, endothelial dysfunction and pathological angiogenesis and may indicate maladaptive cardiac remodeling in severe heart failure.

Author Biographies

O. V. Rasputniak, SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, Cardiologist of the Department of Surgical Arrhythmias Treatment

T. I. Havrylenko, SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv

PhD, DSc, Professor, Head of the Department of Immunology and Biochemistry

K. V. Rudenko, SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, DSc, Professor, Deputy Director for Medical Coordination

N. O. Ryzhkova, SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Researcher of the Department of Immunology and Biochemistry

O. A. Pidhaina, SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Researcher of the Department of Immunology and Biochemistry

O. V. Rybakova, SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, Honored Worker of Science and Technology of Ukraine

V. P. Zalevskyi, SI “National M. Amosov Institute of Cardiovascular Surgery Affiliated to National Academy of Medical Sciences of Ukraine”, Kyiv

MD, Head of the Department of Surgical Arrhythmias Treatment

О. M. Lomakovskyi , SI “National Scientific Center “Institute of Cardiology named after M. D. Strazhesko” of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Researcher of the Department of Atherosclerosis and Chronic Ischemic Cardiovascular Disease

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Published

2021-04-16

How to Cite

1.
Rasputniak OV, Havrylenko TI, Rudenko KV, Ryzhkova NO, Pidhaina OA, Rybakova OV, Zalevskyi VP, Lomakovskyi ОM. Immunopathological reactions, endothelial dysfunction and pathological angiogenesis as independent mechanisms of maladaptive left ventricular remodeling in ischemic and nonischemic heart failure patients. Zaporozhye Medical Journal [Internet]. 2021Apr.16 [cited 2024May20];23(2):175-83. Available from: http://zmj.zsmu.edu.ua/article/view/211951

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Original research