Circulating transforming growth factor-beta levels and myocardial remodeling in young adults with mitral valve prolapse patients

• Published in: Progress in pediatric cardiology Vol. 62; p. 101347
• Main Authors: Malev, Eduard, Luneva, Ekaterina, Reeva, Svetlana, Timofeev, Eugeny, Omelchenko, Marina, Zemtsovsky, Eduard
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.09.2021
• Subjects: Diastolic function; Left ventricular remodeling; Mitral valve prolapse; Transforming growth factor-β; Diastolic function; Mitral valve prolapse; Left ventricular remodeling; Transforming growth factor-β
• ISSN: 1058-9813; 1558-1519
• DOI: 10.1016/j.ppedcard.2021.101347

Left ventricular (LV) remodeling could be found in a range of connective tissue disorders with involvement of transforming growth factor (TGF)-β pathway. Only rare data are available on it in patients with mitral valve prolapse (MVP). The aim of the study is to assess mechanisms of myocardial remodeling and diastolic dysfunction in asymptomatic young patients without mitral regurgitation. 78 asymptomatic young subjects with MVP were consecutively enrolled in our observational, single-center study. Concentrations of TGF-β1 and -β2 in serum were determined by enzyme-linked immunosorbent assay. Standard echocardiography extended with speckle-tracking echocardiography was performed in all patients. Levels of TGF-β1 (15.2 ± 12.3 ng/ml vs. 9.3 ± 7.7 ng/ml; р = 0.004) and -β2 (3.0 ± 1.9 ng/ml vs. 2.5 ± 1.2 ng/ml; р = 0.04) in serum were significantly higher in patients with MVP. LV myocardial mass index in patients with MVP did not differ from the controls but in MVP group there were more patients with concentric and eccentric hypertrophy. Significant deterioration of longitudinal early diastolic strain rate (SRe) was found in patients with MVP in the region of the interventricular septum (1.38 ± 0.22 s-1 vs. 1.54 ± 0.25 s-1; p = 0.00001) and anterior wall (1.44 ± 0.23 s-1 vs. 1.56 ± 0.22 s-1; p = 0.0007). In MVP group level of TGF-β2 correlated with LV mass index and SRe. Multivariate regression analysis between such factors as age and sex detected influence TGF-β2 concentration on SRe (OR 1.95; 95% CI 1.3–4.1; р = 0.01). A circulating TGF-β is involved in the LV remodeling and deterioration of the diastolic function in MVP patients without significant mitral regurgitation, apparently due to the profibrotic nature of this cytokine. •Levels of TGF-β1 and TGF-β2 in the blood serum elevated in MVP patients.•Abnormal geometry of LV is more common in MVP patients then in controls.•Deterioration of regional diastolic SR was found in the IVS and anterior wall.•A circulating TGF-β is involved in the LV remodeling and diastolic disfunction in MVP.