CARDIOVASCULAR REMODELING AND INFLAMMATORY BIOMARKERS IN PATIENTS WITH ARTERIAL HYPERTENSION

Objective: To study the association between cardiovascular remodeling and inflammatory biomarkers in patients with arterial hypertension. Design and method: The study included 135 patients aged 18 to 60 years (mean age – 51.53 ± 6.88, 70 men) with arterial uncontrolled hypertension I-II grades. Inflammatory biomarkers – serum concentrations of highly sensitive C-reactive protein (hs-CRP), interleukin (IL)-1b, IL-6, IL-8, tumor necrosis factor (TNF)-alfa were determined in patients as well as hematological indices – systemic immune inflammation index (SII), monocyte to high-density lipoprotein cholesterol ratio (MHR), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR). Echocardiography, brachiocephalic artery ultrasound and parameters of arterial stiffness by SphygmoCor and VaSera were assessed. Results: In the study group an increasing the left ventricular myocardial mass index (LVMI) was in 61,19% (M-mode) and 48.51% of cases (B-mode), the intima-media thickness (IMT) of the common carotid artery (CCA) – in 30.37% of cases, pulse wave velocity – in 29.09% of cases, cardio-ankle vascular index on at least one side – in 10.37% and a decrease in the ankle–brachial index (ABI) – 5.18%. Positive correlations were obtained between hs-CRP and LVMI in the M-mode (rs=0.255; p=0.003), LV posterior wall thicknesses (LV PWT) (rs=0.204; p=0.009), interventricular septal thickness (IVST) (rs=0.203; p=0.019), LV relative wall thickness (RWT) (rs=0.204; p<0.005); MHR and LVMI in B- and M-modes (rs=0.347; p<0.001 and rs=0.215; p=0.013, respectively), IVST (rs=0.312; p<0.001), LV PVT (rs=0.213; p=0.006); SII and IVST (rs=0.207; p=0.017). Higher values of hs-CRP (p=0.025) and MHR (p=0.035) were found in patients with increased LVMI in B-mode. Correlation analysis revealed a positive relationship between MHR and IMT CCA on the right (r=0.23; p=0.007) and on the left (r=0.29; p<0.001), TNF-alfa and vascular age (r=0.28; p=0.007) and a negative relationship between hs-CRP and ABI on the left (r=-0.20; p=0.022). Higher IL-8 values were found in patients with reduced ABI (p=0.050). Conclusions: Heart hypertrophy was associated with biomarkers of inflammation hs-CRP, MHR, SII; arterial damage – with hs-CRP, TNF-alfa and MHR, which may indicate the involvement of immune cells and cytokines in the process of cardiovascular remodeling in patients with arterial hypertension.