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Blood Immune Cell Alterations in Patients with Hypertensive Left Ventricular Hypertrophy and Heart Failure with

Artem Ovchinnikov1,2, Anastasiya Filatova1,3, Alexandra Potekhina1

  • 1Laboratory of Myocardial Fibrosis and Heart Failure with Preserved Ejection Fraction, Institute of Clinical Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, 121552 Moscow, Russia.

Journal of Cardiovascular Development and Disease
|July 28, 2023
PubMed

Insights

In patients with left ventricular hypertrophy (LVH), a lower regulatory T-cell (Treg) to activated T-helper (Th-act) cell ratio and increased intermediate monocytes are linked to heart failure with preserved ejection fraction (HFpEF) and diastolic dysfunction.

Area of Science:

  • Cardiology
  • Immunology
  • Cell Biology

Background:

  • Chronic inflammation and fibrosis drive cardiac remodeling in left ventricular hypertrophy (LVH) and heart failure with preserved ejection fraction (HFpEF).
  • Monocytes and T-helper cells (Th) contribute to inflammation and fibrosis, while regulatory T-cells (Treg) may mitigate these processes in the hypertrophied heart.

Purpose of the Study:

  • To investigate the association between circulating CD4+ T-cell and monocyte subpopulations and left ventricular (LV) diastolic function in LVH patients, stratified by HFpEF presence.
  • To determine if immune cell profiles differ between asymptomatic LVH and LVH with HFpEF.

Main Methods:

  • Echocardiography and clinical assessment of 57 patients with asymptomatic hypertensive LVH (n=21) or LVH with HFpEF (n=36).
  • Flow cytometry and direct immunofluorescence to quantify CD4+ Treg, activated Th (Th-act), and monocyte subsets (classical, intermediate, non-classical).

Main Results:

  • Patients with HFpEF exhibited a significantly lower Treg/Th-act ratio compared to asymptomatic LVH patients (p=0.001).
  • No significant differences in total monocyte counts or subsets were observed between the groups.
  • Moderate correlations were found between intermediate monocyte counts and echocardiographic measures of LV diastolic dysfunction in HFpEF patients.

Conclusions:

  • T-cell imbalance, specifically a reduced Treg/Th-act ratio, is associated with the progression from asymptomatic LVH to HFpEF.
  • Elevated intermediate monocyte counts may correlate with worsening LV diastolic dysfunction in the context of LVH and HFpEF.

Keywords:
T-cellsdiastolic dysfunctionheart failure with preserved ejection fractionleft ventricular hypertrophymonocytestype 2 diabetes mellitus

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