Key result
Overall Z-scores for low-grade inflammation and endothelial dysfunction were not associated with echocardiographic measures of cardiac structure and function, despite some sex-specific associations for individual biomarkers.
Why the study?
It was unknown whether within-person and between-persons associations of low-grade inflammation and endothelial dysfunction with diastolic dysfunction-related echocardiographic measures differ by sex in the general population.
Are low-grade inflammation and endothelial dysfunction associated with longitudinal changes in echocardiographic measures of diastolic dysfunction, and do these associations differ by sex?
Cohort (n=874)
Yes
Are low-grade inflammation and endothelial dysfunction associated with longitudinal changes in echocardiographic measures of diastolic dysfunction, and do these associations differ by sex?
Longitudinal changes in low-grade inflammation and endothelial dysfunction biomarkers are not consistently associated with echocardiographic measures of diastolic dysfunction in the general population, despite some sex-specific variations.
BACKGROUND: This study aimed to determine the within-person and between-persons associations of low-grade inflammation (LGI) and endothelial dysfunction (ED) with echocardiographic measures related to diastolic dysfunction (DD) in two general populations and whether these associations differed by sex. METHODS: Biomarkers and echocardiographic measures were measured at both baseline and follow-up in the Hoorn Study (n = 383) and FLEMENGHO (n = 491). Individual biomarker levels were combined into either a Z-score of LGI (CRP, SAA, IL-6, IL-8, TNF-α and sICAM-1) or ED (sICAM-1, sVCAM-1, sE-selectin and sTM). Mixed models were used to determine within-person and between-persons associations of biomarker Z-scores with left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) and left atrial volume index (LAVI). These associations were adjusted for a-priori selected confounders. RESULTS: Overall Z-scores for LGI or ED were not associated with echocardiographic measures. Effect modification by sex was apparent for ED with LVEF in both cohorts (P-for interaction = 0.08 and 0.06), but stratified results were not consistent. Effect modification by sex was apparent for TNF-α in the Hoorn Study and E-selectin in FLEMENGHO with LVEF (P-for interaction≤0.05). In the Hoorn Study, women whose TNF-α levels increased with 1-SD over time had a decrease in LVEF of 2.2 (-4.5;0.01) %. In FLEMENGHO, men whose E-selectin levels increased with 1-SD over time had a decrease in LVEF of 1.6 (-2.7;-0.5) %. CONCLUSION: Our study did not show consistent associations of LGI and ED with echocardiographic measures. Some evidence of effect modification by sex was present for ED and specific biomarkers.
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Remmelzwaal et al. (2021) conducted a cohort in Low-grade inflammation and endothelial dysfunction (n=874). Low-grade inflammation and endothelial dysfunction vs. Lower levels of inflammation and endothelial dysfunction was evaluated on Echocardiographic measures (LVEF, LVMI, LAVI). Overall Z-scores for low-grade inflammation and endothelial dysfunction were not associated with echocardiographic measures of cardiac structure and function, despite some sex-specific associations for individual biomarkers.
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