Soluble Tumor Necrosis Factor Receptor 1 Level Is Associated With Left Ventricular Hypertrophy: The Northern Manhattan Study

Abstract

BACKGROUND Although inflammatory markers may be associated with risk of cardiovascular events, few data are available regarding these markers and their association with left ventricular hypertrophy (LVH). We sought to evaluate whether inflammatory markers were independently associated with LVH in a multiethnic population in northern Manhattan. METHODS A population-based cross-sectional study was conducted in 660 participants without stroke, who had undergone both transthoracic echocardiography and testing for soluble tumor necrosis factor receptor (sTNFR) 1, interleukin (IL)-6, and high-sensitivity C-reactive protein (hsCRP). LV mass was calculated according to an established formula. LVH was defined as LV mass greater than the 90th percentile of the participants. RESULTS The mean age was 67.4 ± 8.8 years, 35.5% were men, 61.7% were Hispanic, 19.7% were black, and 18.6% were white. In univariate analyses, hsCRP, IL-6 and sTNFR1 were significantly associated with LV mass. Multiple linear regression analyses demonstrated that sTNFR1 (P = 0.0008) was associated with LV mass after adjusting for demographic and medical risk factors, but hsCRP and IL-6 were not. When all markers were included in the same model, sTNFR1 remained significant, but hsCRP and IL-6 did not. Compared with the lowest quartile of sTNFR1, those in the highest quartile were more likely to have LVH (Odds ratio = 1.84, 95% Confidence interval, 0.97 to 3.64, P = 0.06). CONCLUSIONS Soluble TNFR1, but not hsCRP nor IL-6, is independently associated with increased LV mass. Chronic subclinical inflammation including the TNFR1-associated system may contribute to LVH.

Soluble tumor necrosis factor receptor 1 (sTNFR1) is associated with increased total mortality due to cancer and cardiovascular causes – Findings from two community based cohorts of elderly

“…Soluble TNFR1 was shown to be cross-sectionally associated with cardiometabolic risk factors in a study of patients with coronary artery disease: elevated uric acid levels, lower HDL cholesterol, metabolic syndrome, diabetes and heart failure [21]. In accordance with our findings where sTNFR1 was associated with cardiovascular mortality after adjustments for CRP and IL-6, sTNFR1 but not IL-6 and CRP was associated with left ventricular mass in a study of over 600 patients with stroke [22]. Elevated levels of sTNFR1 and STNFR2 have also been associated with incident coronary heart disease in women with a low kidney function [23,24], and elevated levels of sTNFR2 were associated with incident coronary heart disease independently of hyperglycemia a 10-year follow-up of almost one thousand nurses with diabetes [25].…”

A Mediterranean-Style Diet and Left Ventricular Mass (from the Northern Manhattan Study)

“…Inflammation is one possible link, as a DT has been shown to be associated with lower levels of inflammatory markers 13-15 . A prior study in this cohort found that levels of TNF receptor 1 were associated with LV mass and LV hypertrophy 16 . In the current study a DT was inversely associated with several important vascular risk factors associated with LV mass, most notably obesity.…”

The Metabolic Syndrome and Cognitive Performance: The Northern Manhattan Study

“…Elevated TNFR1 levels were associated with lower MMSE score in our cohort, but we did not confirm that the relationship between MetS and MMSE score was mediated through inflammation, as suggested by other studies [34] . Elevation of TNFR1 has also been associated with decreased memory performance [35] and it may be a reflection of the inflammatory mechanisms operative in atherosclerotic disease as it has been shown to be associated, in our cohort and others, with increased carotid plaque [36] , left ventricular hypertrophy [16] and vascular dementia [37] .…”

“…Serum amyloid A (SAA) and high-sensitivity C-reactive protein (hsCRP) were measured using the BNII nephelometric assay system (Dade-Behring, Deerfield, Ill., USA) [15] . Interleukin-6 (IL-6) and tumor necrosis factor receptor 1 (TNFR1) were measured by enzyme-linked immunosorbent assays according to manufacturer instructions (BioSource International, Camarillo, Calif., USA), as previously described [16] .…”