Relationship between myocardial dysfunction and soluble glycoprotein 130 in hemodialysis patients

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  • 血液透析患者の心筋障害とｓｏｌｕｂｌｅ　ｇｌｙｃｏｐｒｏｔｅｉｎ　１３０
  • ケツエキ トウセキ カンジャ ノ シンキン ショウガイ ト soluble glycoprotein 130

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Abstract

Recently, it has been reported that glycoprotein (gp) 130 is a common signal-transducing receptor subunit for the IL-6 cytokine family, and in the non hemodialysis (HD) patients, plasma levels of its soluble form (soluble gp 130; sgp 130) are elevated in association with the severity of heart failure. However, in HD patients, the relationship between the damage of cardiomyocytes and sgp 130 is unclear, so we performed an echocardiogram and investigated all echocardiographic measurements and also measured several blood chemistry tests and the plasma levels of sgp 130 according to the manufacturer's instructions with an enzyme-linked immunosorbent assay purchased from R & D Systems (Minneapolis, MN, USA) in 108 patients (74 HD patients, 34 non HD patients).<br>In the HD group, the plasma level of sgp 130 was significantly greater than that in the non HD group (p<0.05). In the HD group, sgp 130 was positively correlated with left ventricular mass index, left ventricular relative wall thickness (RWT), inter ventricular septal thickness and left ventricular posterior wall thickness (r=0.248, p<0.05; r=0.356, p<0.005; r=0.405, p<0.0005; r=0.337, p<0.005, respectively), and was also negatively correlated with ejection fraction, percent fractional shortening, stroke volume, cardiac output and cardiac index (r=-0.327, p<0.005; r=-0.268, p<0.05; r=-0.348, p<0.005; r=-0.269, p<0.05; r=-0.288, p<0.05, respectively). In the HD group, sgp 130 level was significantly greater in the RWT high group (RWT≥0.45) than in the RWT low group (RWT<0.45) (p<0.0005), and sgp 130 level was significantly greatest in the left ventricular concentric hypertrophy group (p<0.005). In the HD group, multiple regression analysis of sgp 130 demonstrated that left ventricular systolic dysfunction and RWT were significantly influential factors. In the HD group, for the detection of left ventricular systolic dysfunction, the area under the ROC curve was 0.822 (p<0.0001) for sgp 130, and the cut-off value was 383 (ng/mL).<br>In conclusion, the signal-transducing pathway via activation of gp 130 may play an important pathophysiological role in heart failure, cardiac remodeling, and cardiomyopathy in HD patients.

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