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To study the change of serum high mobility group box 1 protein(HMGB1), tumor necrosis factor-α(TNF-α), Heart-Type Fatty Acid Binding Protein(H-FABP) in elderly anemic patients with congestive heart failure(CHF). and observe their influence on left ventricular mass index(LVMI), mean wall stress(MWS) and cardiac function.
A total of 121 consecutive elderly patients with CHF and 27 healthy subjects with matched age and sex were enrolled, and CHF patients were divided into Anemic group(n= 45) and non- anemic group(n= 76) according to Hb concentrations. Serum levels of HMGB1, TNF-α,H-FABP were measured by ELISE. left ventricular ejection fraction(LVEF), LVMI and MWS were detected by echocardiography.
LVEF and Hb concentration in patients with CHF were lower than that in healthy subjects [(38.99±11.56)% vs(68.73±7.05)%, (131.25±31.87) g/l vs(162.41±7.68) g/l], and the levels of HMGB1,TNF-α,H-FABP were on the contrary [(67.65±7.84) pg/ml vs (9.52±1.82) pg/ml], (82.42±42.13) ng/L vs (25.26±5.23) ng/L, (45.33 ±9.83) ng/L vs (19.21 ±4.30) ng/mL, all p<0.01, respectively]. HMGB1,TNF-α,H-FABP levels and LVMI and MWS have higher values in the anemic patients with CHF compared with patients without anemia [(37.65±5.34) pg/ml vs (19.83±2.91) pg/ml], (92.33±6.39) ng/L vs (55.63±10.16) ng/L,(51.04±5.23) ng/L vs (31.86±4.87) ng/mL,(187.7±8.5) vs (108.4±9.3) g/m2 and (481.1±25.8) vs (361.8±23.1) dynes×103/cm2, all p<0.01, respectively], LVEF were on the contrary [(33.94±5.23)% vs (45.35±8.82)%, p<0.01]. There was positive correlation between H-FABP and HMGB1, TNF-α, Serum levels of H-FABP positively correlated with LVMI, MWS in the anemic patients with CHF(P<0.01).
Significant increase in the H-FABP was in accord with changes in serum levels of HMGB1 and TNF-α, Significant cytokines Activation play roles in pathophysiological and pathogenetic mechanism of the severity of ventricular remodeling and result in substantial increase in H-FABP levels, and the occurrence of anemia aggravates the change of ventricular remodeling in CHF.