Inflammatory markers and circulating extracellular matrix proteins in patients with chronic obstructive pulmonary disease and left ventricular diastolic dysfunction. (6th January 2016)

• Record Type: Journal Article
• Authors: López‐Sánchez, Marta; Muñoz‐Esquerre, Mariana; Huertas, Daniel; Montes, Ana; Molina‐Molina, María; Manresa, Federico; Dorca, Jordi; Santos, Salud
• Is Part Of: Clinical respiratory journal. Volume 11:Number 6(2017)
• Page Start: 859
• Page End: 866
• Publication Date: 2016-01-06
• Subjects: COPD -- extracellular matrix proteins -- inflammatory biomarkers -- left ventricular diastolic function -- tenascin‐C; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12428
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Background: Left ventricular diastolic dysfunction (LVDD) is a frequent condition in chronic obstructive pulmonary disease (COPD). Tenascin‐C (Tn‐C) and matrix metalloproteinase‐9 (MMP‐9) are extracellular matrix proteins associated with myocardial fibrosis and wall remodeling because of inflammation. Objective: To determine whether the circulating levels of inflammatory markers, Tn‐C and MMP‐9 are associated with LVDD in COPD patients. Methods: Forty‐two severe stable COPD patients (64 ± 8 years, 88% male, FEV1% 38 ± 5.7) and a control group ( n = 11) were included. Pulmonary function tests and a Doppler echocardiography were performed on COPD patients. Baseline serum levels of C‐reactive protein (CRP), leukocytes, fibrinogen, interleukins (IL) 6 and 8, Tn‐C and MMP‐9 were analyzed in all participants. Results: COPD patients were classified in two groups: LVDD ( n = 35) and non‐LVDD ( n = 7). Serum levels of IL‐6 and CRP were higher in the LVDD group compared to the non‐LVDD group [median(IQR)] [3.46 pg/mL (2.36–4.74) vs 1.87 pg/mL (1.10–3.28), P = 0.045] and [6.0 mg/L (3.0–13.0) vs 1.0 mg/L (1.0–2.3), P = 0.001], respectively. The same trend was observed in the analysis adjusted by age and BMI, being significant for CRP ( P = 0.04). Circulating IL‐6 was associated with the type of LVDD, being higher in the type‐II ( P = 0.046). Obese patients with COPD‐LVDD showed a higher level of inflammatory markers ( P = 0.021). Tn‐C were significantly higher in patients with LVDD type‐II compared to type‐I [1422 ng/mL (826–1948) vs 781 ng/mL (640–1139), P = 0.015], without differences in MMP‐9. Conclusions: Severe COPD patients with LVDD showed a different inflammatory pattern, suggesting a link between low‐grade inflammation and the presence of LVDD. In COPD, high levels of Tn‐C are related to LVDD type‐II.