Arterio-venous gradient of active interleukin-18 is associated with diastolic dysfunction: a cross-sectional study

Hirofumi Makino1, Yu Yasuda2, Yusuke Morita2

  • 1Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.

ESC Heart Failure
|February 19, 2026
PubMed

Insights

Local interleukin-18 (IL-18) gradients are associated with diastolic dysfunction in heart failure patients. Higher arterio-venous ratios of active IL-18 correlate with impaired myocardial relaxation, especially in those with elevated filling pressures.

Area of Science:

  • Cardiology
  • Immunology
  • Biochemistry

Background:

  • Diastolic dysfunction is a major factor in heart failure (HF) symptoms and prognosis.
  • Interleukin-18 (IL-18) and IL-6 are key inflammatory cytokines in HF, but their local roles are unclear.
  • This study explores the link between arterio-venous (A/V) cytokine gradients and diastolic dysfunction.

Purpose of the Study:

  • To investigate the association between A/V gradients of active IL-18 (aIL-18) and active IL-6 (aIL-6) and diastolic dysfunction.
  • To evaluate the relationship between these cytokine gradients and echocardiographic and clinical parameters of diastolic dysfunction.
  • To assess the in vitro effects of aIL-18 on cardiac fibroblasts.

Main Methods:

  • Eighty-seven heart failure patients undergoing cardiac catheterization were enrolled.
  • Paired arterial and venous blood samples were analyzed for aIL-18 and aIL-6 concentrations.
  • Associations with echocardiographic measures (e.g., E/e'), clinical scores (HFA-PEFF), and in vitro fibroblast responses were evaluated.

Main Results:

  • The cohort had impaired myocardial relaxation with preserved ejection fraction.
  • The aIL-18 A/V ratio correlated with markers of diastolic dysfunction, including average E/e', tricuspid regurgitation pressure gradient, and HFA-PEFF score.
  • These correlations were stronger in non-diabetic patients and those with elevated LV filling pressure; aIL-18 stimulated fibroblast proliferation and collagen synthesis in vitro.

Conclusions:

  • Local IL-18 gradients, indicated by the aIL-18 A/V ratio, are associated with diastolic dysfunction in heart failure.
  • The findings suggest a role for local IL-18 in diastolic dysfunction, particularly in patients with increased filling pressures.
  • Further research is warranted to confirm these exploratory findings and elucidate the mechanisms involved.
Abstract

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