In active juvenile dermatomyositis, elevated eotaxin and MCP-1 and cholesterol levels in the upper normal range are associated with cardiac dysfunction.

Thomas Schwartz, Ivar Sjaastad, Berit Flatø, Maria Vistnes, Geir Christensen, Helga Sanner

Journal: Rheumatology (Oxford, England) 2015;53(12):2214-22

PMID: 24996906

Abstract

OBJECTIVE

The aim of this study was to examine the influence of chemokines and lipids on cardiac function in patients with active and inactive JDM and matched controls.

METHODS

Fifty-four JDM patients were clinically examined a median 16.8 years (range 2-38) after disease onset and compared with 54 sex- and age-matched controls. Inactive disease was defined by the PRINTO criteria. Serum levels of chemokines were analysed by Luminex technology. Echocardiography was performed and analysed blinded to patient information. Long-axis strain and e' were used as parameters of systolic and diastolic function, respectively.

RESULTS

In patients, but not in controls, eotaxin and monocyte chemoattractant protein 1 (MCP-1) correlated with systolic (r = -0.65 and r = -0.45) and diastolic (r = -0.59 and r = -0.65) function, particularly in those with active disease (systolic function, r = -0.74 and r = -0.60; diastolic function, r = -0.69 and r = -0.80). Total cholesterol level was lower in patients than controls [mean 4.19 mmol/l (s.d. 0.82) vs 4.60 (0.87), P ≤ 0.01]. However, total cholesterol levels in the upper normal range were associated with systolic (r = -0.56, P < 0.01) and diastolic (r = -0.64, P < 0.001) dysfunction and with high eotaxin and MCP-1 (r = 0.56 and r = 0.50, P < 0.01) in patients with active disease, but not in those with inactive disease or in controls (all r < ±0.2).

CONCLUSION

In the active disease state of JDM, eotaxin and MCP-1 were associated with cardiac dysfunction, possibly through sustained inflammation. In those with active disease and cholesterol levels in the upper normal range, eotaxin and MCP-1 might enhance susceptibility to cardiac dysfunction.

© The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: [email protected].

Address: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway [email protected].; Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.; Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.; Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.; Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
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