Transforming Growth Factor β1 and Myocardial Remodeling in Patients with Chronic Heart Failure of Ischemic Genesis

Aim . To study the presence and nature of correlations between the level of transforming growth factor β1 (TFR-β1) and structural and functional parameters of the heart in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin. Material and methods . The study included 120 men with class II-IV CHF who have history of myocardial infarction, which are divided into 3 groups depending on the CHF class. The control group included 25 healthy men. Assessment of left ventricular (LV) structural-functional state was carried out by echocardiography. Investigation of TFR-β1 and N-terminal precursor indices of cerebral natriuretic peptide (NT-pro BNP) was performed by enzyme immunoassay. Results . Patients with class II-IV CHF were hyperexpression of ТФР-β1, the levels of which increased significantly as NYHA class increased and CHF progressed. The most significant structural-geometric rearrangement of LV and hyperactivation ТФР-β1 recorded in patients with class IV CHF (77.2±6.33 ng/ml with class IV CHF versus 46.7±3.74 ng/ml and 58.9±4.75 ng/ml with class II and III CHF; р< 0.05). In patients of class III-IV CHF, correlation relationships between ТФР-β1 level and echocardiographic parameters (LV myocardial mass index are established: r = 0.56, p = 0.05; end systolic volume index: r = 0.52, p = 0.05; value of LV ejection fraction: r = -0.48, p=0,05). Significant direct relationships are established in patients with class III-IV CHF between ТФР-β1 level and NT-rgo BNP levels (r=0,44; р=0,05). Conclusion . The intensity of myocardial remodeling and fibrosis processes in patients with a progressive course of CHF is related to ТФР-β1 hyperexpression and is associated with a high level of activity of natriuretic peptides.