Vіsnik Naukovih Doslіdžen' (Aug 2017)
ADIPOCYTOKINES METABOLISM AND IMMUNE-PATHOLOGIC CHANGES IN CHRONIC HEART FAILURE PATIENTS WITH OVERWEIGHT AND OBESITY ASSOCIATED ATRIAL FIBRILLATION
Abstract
Atrial fibrillation (AF) is associated with increased risk of progression of chronic heart failure (CHF) and death. Significant factors of onset of AF in patients with CHF is a significant age, male sex, diabetes, valvular heart disease, and obesity. Recently more and more researchers focus on the study of the role adipocytokines and indexes of systemic immune inflammation in the occurrence of AF in CHF. The aim of the study – to investigate adipocytokines metabolism and immune-pathological changes in CHF patients with overweight, obesity and concomitant atrial fibrillation (AF), by determining the serum content of adiponectin, resistin, interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α). Materials and Methods. We examined 117 patients. The main group included patients with CHF II-III functional class with normal, overweight and obesity I-III degree. According to the purpose of the study, the patients with CHF were divided into 2 subgroups: with concomitant AF (38 patients (36.2 %)), and without concomitant AF (67 patients (63.8 %)). CHF was the result of chronic forms of ischemic heart disease (IHD), arterial hypertension (AH) and combinations thereof. The comparison group was 12 patients with chronic forms of IHD and AH, with normal weight, without clinical and instrumental signs of CHF. Calculating the body mass index (BMI) were set the normal weight, overweight and degree of obesity. By ELISA in the serum of blood we determined the level of adiponectin, resistin, IL-6, IL-10 and TNF-α. Results and Discussion. It is established that in CHF patients with overweight, obesity and related AF adipocytokines metabolism is characterized by a predominance of activity of adiponectin and resistin in the blood serum. The presence of AF in CHF patients with excess weight were accompanied by more severe manifestations immune-pathological changes in the form of significantly higher values as proinflammatory IL-6, TNF-α and anti-inflammatory IL-10. Conclusions. Concomitant atrial fibrillation in CHF with overweight and obesity is associated with excessive activation of adipocytokines system in parallel with more severe manifestations immune-pathological changes.
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