Circulating heat shock proteins and inflammatory markers in patients with idiopathic left ventricular dysfunction: their relationships with myocardial and microvascular impairment

Abstract

Little information is available on peripheral levels of Hsp72, Hsp60, and anti-Hsp60 antibodies in patients with left ventricular (LV) dysfunction due to non-atherosclerotic cardiac disease. In this study, serum Hsp72, Hsp60 and anti-Hsp60 antibodies, IL-6, and C-reactive protein (CRP) were measured in 44 healthy controls and in 82 patients with angiographically normal coronary arteries (LV ejection fraction [EF] > or = 50%, n=22; -35% to <50%, n=32; <35%, n=28). Patients with more severe disease (more depressed myocardial blood flow at rest and during dipyridamole, indicative of coronary microvascular impairment) showed more elevated circulating Hsp60 and auto-antibodies, Hsp72, and CRP levels. IL-6 was increased progressively as a function of severity of LV dysfunction. Anti-Hsp60 antibodies, Hsp72, and IL-6 were significantly correlated with brain natriuretic peptide (BNP) levels and LV end-diastolic dimensions (LVEDD) values. IL-6 tended to be related with Hsp72 in particular in patients with more severe disease (r = 0.45, P = 0.021). Hsp60 and Hsp72 activation and inflammatory markers were correlated with the extent of cardiac and microvascular dysfunction in patients with angiographycally normal coronary arteries. These results suggest a pathogenic role of infective-metabolic insult and inflammatory reaction in the development of vascular and myocardial damage in patients with heart failure even in the absence of overt coronary artery disease.

High-sensitivity C-reactive protein (hs-CRP) as a biomarker for trastuzumab-induced cardiotoxicity in HER2-positive early-stage breast cancer: a pilot study

“…In 2000, Ridker et al [22] found elevated hs-CRP to be predictive of cardiovascular disease in women. Elevated hs-CRP has since been associated with poor prognostic indicators, such as decreased LVEF and diastolic dysfunction, in patients with a variety of cardiovascular maladies including acute myocardial infarction [23], chronic stable angina [24], left ventricular systolic heart failure [17], idiopathic left ventricular dysfunction [16], and congestive heart failure [15,25]. The results LVEF left ventricular ejection fraction, HRT/OCP hormone replacement therapy/oral contraceptive pills presented here suggest that elevated serum hs-CRP may also be useful as a biomarker for early detection of risk for cardiotoxicity in breast cancer patients undergoing adjuvant trastuzumab treatment combined with standard chemotherapy.…”

“…BNP is synthesized in the ventricles of the heart and secreted in response to volume expansion and pressure overload; CRP is an acute phase protein produced by hepatocytes during periods of inflammation; and cTnI is located in the contractile apparatus of myocytes and is released upon necrosis. Several studies have demonstrated that BNP, hs-CRP, and/ or cTnI elevation correlates with cardiac dysfunction ranging in severity from asymptomatic decrease in LVEF to heat failure [10][11][12][13][14][15][16][17]. We hypothesized that elevated levels of serum BNP, hs-CRP, and/or cTnI may be indicative of trastuzumab-induced cardiotoxicity.…”

The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence

“…Another potential mechanism of THinduced cardioprotection is the increased expression of heat shock proteins such as HSP-27 and HSP-70, two redox-regulated molecular chaperones that enhance cell survival under stress [123,124]. This TH effect seems particularly interesting since in patients with left ventricular dysfunction due to non-atherosclerotic cardiac disease, serum levels of heat shock proteins, IL-6 and CRP are elevated and the entity of this elevation is associated with a more severe disease as evidenced by a more depressed myocardial blood flow at rest and during dypiridamole, indicative of microvascular impairment [125].…”

A systematic review of the effectiveness of oral health promotion activities among patients with cardiovascular disease

“…One example is C-reactive protein (CRP), which has been shown to be highly predictive of cardiovascular disease development [20][21][22][23]. Other systemic inflammatory markers that have been associated with cardiovascular disease include interleukin-6 (IL-6) [24][25][26], white blood cell (WBC) counts [27][28][29], and fibrinogen [30,31]. Endothelial dysfunction [32,33], as well as carotid intima media thickness (IMT) [34][35][36], may also serve as surrogate endpoints of cardiovascular disease risk.…”