The Correlation Of TGF-α And NF-κB With Cardiovascular Remodeling In Elderly Cardiopathy Patients

Objective:To investigate the correlation of transforming growth factor-α(TGF-α), nuclear factor-κB (NF-κB) with carotid artery, brachial artery remodeling and of cardiac remodeling in elderly patients with hypertension and elderly hypertensive patients with coronary heart disease. Methods: (1) In the early morning gathering experimental group and the control group fasting circumference blood serum. To measure the serum concentrations of TGF-αby RIA of 37 cases of elderly patients with hypertension, 34 cases of elderly hypertensive patients with coronary heart disease and 16 cases of normal control group. (2) Extracting of experimental group and control group fasting peripheral blood mononuclear cells, and manufacturing cell smears,then using immunohistochemical method to detect the nuclear factorκB activation expression rate.(3) Use vascular ultrasound detects the arteria carotis communis intima-media thickness (CCAIMT),carotid diameter, carotid artery blood flow velocity and carotid artery plaque formation. Compute carotid plaque score according to the Crouse method. Detect brachial artery diameter and the brachial artery intima-media thickness (gdmIMT). Other echocardiography parameters was also detected and recorded, such as diastolic diameter, thickness of the IVS and LV posterior wall, ejection fraction, the ratio of left ventricular fractional shortening (FS), the mitral early and late diastolic flow velocity MVe, MVa. Calculate the left ventricular mass (LVM) according to Devereux formula (LVM=1.04×[(IVST+LVPWT+VDd)3-LVEDd3] -13.6), left ventricular mass index [LVMI=LVM/BSA, body surface area (BSA) =0.006×body length(cm)+0.013×weight (kg)]. Results: The TGF-α, NF-κB level of patient with hypertension and coronary heart disease was significantly higher than the hypertension group, and the level of hypertension group was significantly higher than the normal control group. TGF-αserum level and peripheral blood mononuclear cell NF-κB activation rate were significantly positively correlated (r=0.678,P<0.01), linear regression equation was y=10.28+0.848x. There was a positive correlation among TGF-α, NF-κB levels and vascular remodeling indicators, which can reflect by carotid artery, brachial artery diameter, intima-media thickness and vascular wall/cavity ratio,carotid artery plaque score, carotid artery resistance index and pulsatility index.TGF-αlevel is positively correlated with left ventricular diastolic diameter, thickness of the IVS, LV posterior wall and LVMI, those are indicators of cardiac remodeling. And TGF-αlevel also negatively correlated with EF, FS, which reflect the cardiac systolic function. NF-κB level and ventricular septal thickness, left ventricular mass index are positively correlated. The relationship between NF-κB level and EF values are negative correlation. Conclusion: (1) Hypertension and coronary atherosclerosis two diseases are both cause and effect relation, promote mutually. Both of them are related to the pathogenesis of vascular inflammation, and those pathological bases for cardiovascular remodeling. (2) Blood serum TGF-αlevel and peripheral blood monocyte NF-κB activation rate related. TGF-αpossibly through NF-κB participates in the cell signal transduction. (3) TGF-α, NF-κB serum levels and carotid artery, brachial artery IMT related; and they also related with left ventricular enlargement, left ventricular mass index and left ventricular systolic function. Both TGF-αand NF-κB are cardiovascular remodeling index of elderly cardiovascular disease and poor prognosis indicators.