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Heart failure is considered to be a chronic inflammatory disease. High mobility protein B1(HMGB1) is a sensitive marker of the body, s nonspecific inflammation. Soluble advanced glycation end product receptor(sRAGE) can competitively combine with HMGB1 to reduce and inhibit inflammation, thus delaying the occurrence and development of heart failure. Changes in pathophysiological functions are reported. yet, Few study have explored the effect of different altitude hypoxia (2260m, 3300-3500m) on HMGB1 and sRAGE in elderly patients(≥65 years old) with congestive heart failure, and to evaluate the relationship with left ventricular mass index (LVMI), mean wall stress(MWS) and cardiac function.
A total of 129 consecutive patients with CHF with matched age and sex were enrolled, and CHF patients were divided into high altitude group(3300m) (n= 62) and moderate altitude group(2260m) (n=67) according to altitude. the serum levels of HMGB1 and sRAGE were detected. Their LVMI and MWS were measured by echocardiography.
Compared with moderate altitude group, the serum levels of HMGB1 and sRAGE were obviously increased in high altitude group[(42.87+17.86) pg/ml vs (26.75+15.22) pg/ml and (1.78+10.74)ng/mlvs(0.82+10.45)ng/ml respectively]. Similarly,LVMI and MWS were significantly higher in high altitude group (189.7+19.5) vs (96.3+18.4) g/m2 and (476.2+114.9) vs (304.7+113.5) dynes x103/cm2，respectively, all p<0.01]. there was a positive correlation between LVMI,MWS and the levels of HMGB1 and sRAGE (all P<0.01).
CHF patients had higher levels of HMGB1 and sRAGE at high altitude, and ventricular remodeling in CHF change With the altitude level severely. The changes LVMI and MWS were more related to higher level of HMGB1 and sRAGE. the increasing in the levels of inflammatory cytokines pay important roles in pathophysiological and pathogenetic mechanism of ventricular remodeling in CHF from high altitude.