Vnitr Lek 2005, 51(9):965-970

Big endothelin, interleukin 6 and right ventricle function

L. Špinarová^1,*, J. Toman^1,†, J. Meluzín¹, P. Hude¹, J. Krejčí¹, H. Pavelčíková¹, J. Tomandl², J. Vítovec¹

¹ I. interní kardio-angiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc., FESC

² Biochemický ústav Lékařské fakulty MU, Brno, přednosta prof. MUDr. Vladimír Palyza, CSc.

Objective:
Big endothelin (BE) and interleukin 6 (IL 6) belong to important active substances, which are related to severity of heart failure. We compared patients with high and low levels of BE and IL 6 in relation to haemodynamics, left (LV) and right ventricle (RV) functions.


Population:
155 patients with chronic heart failure, left ventricular ejection fraction (LVEF) below 40 %, NYHA II-IV, mean age 51.8 ± 8.8 years, 129 men, 26 women. 86 patients were diagnosed with ischaemic heart disease (IHD), 69 patients had dilatation cardiomyopathy (DCMP).

Methods:
Echocardiography with LV sizes, LV volumes and LVEF measurements, tissue Doppler echocardiography (TDE) of tricuspidal annulus movements with systolic rate (Sa) determination, early diastolic (Ea) and late diastolic rate (Aa), right-sided catheterisation with mean pressure in pulmonary artery (PA), pulmonary capillary wedge pressure (PCWP), atrial pressure (CVP), and pulmonary vascular resistance (PVR) measurements. Values of big endothelin and interleukin 6 were determined by means of ELISA method. Median value of big endothelin was 1.66 pmol/l, median value of interleukin 6 was 2.3 ngl/l. Group A had BE ≥ 1.66 pmol/l, group B < 1.66 pmol/l. In IL 6 assessment group A' had level ≥ 2.3 ng/l and group B' < 2.3 ng/l.

Results:
Patients with higher level of BE, group A, had values markedly higher during right-sided catheterisation: PA 31.5 ± 12.8 vs. 23.9 ± 11.6 mm Hg, p < 0.0004, PCWP 22.1 ± 9.8 vs. 16.4 ± 9.1 mm Hg, p < 0.005. Sa, which reflects RV systolic function, was lower in group A: 10.4 ± 2.3 vs. 11.6 ± 2.4 cm/s, p < 0.02. Likewise RV size was higher in group A: 34.0 ± 7.0 vs. 30.8 ± ± 6.5 mm, p < 0.03. Patients with higher value of IL 6, group A', had larger size of RV as well, 34.0 ± 7.4 vs. 30.1 ± 6.4 mm, p < 0.03, and lower Sa: 10.4 ± 2.2 vs. 11.8 ± 2.4 cm/s, p < 0.0005. There were no differences between groups during right-sided catheterisation: AP 27.9 ± 12.6 vs. 27.3 ± 12 mm Hg, non-significant, and PCWP 19.1 ± 9.8 vs. 19.7 ± 10.0 mm Hg, non-significant.

Conclusion:
Big endothelin and interleukin 6 levels are higher in patients who have systolic dysfunction of the left ventricle accompanied with more pronounced disorder of the right ventricle function than in patients who have disorder of the left cardiac ventricle only.

Keywords: big endothelin; interleukin 6; right ventricle; tissue Doppler imaging

Received: November 24, 2004; Accepted: February 2, 2005; Published: September 1, 2005  Show citation