Inflammation may contribute to an increase in cardiac wall stress through multiple pathways related to cardiac remodeling. Cardiac remodeling is a compensatory mechanism characterised by myocyte hypertrophy, myocyte death and modifications of the extra-cellular matrix. We aimed to explore associations of inflammation and myocardial injury with cardiac remodeling in a bi-ethnic sex cohort of South Africa.Design and Method:
We included 165 men (76 African and 89 Caucasian) and 174 women (80 African and 94 Caucasian) participants between 20 and 65 years of age. Inflammatory markers that were employed were C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-alpha (TNF-α), while troponin T (Trop T) and the N-terminal of pro B-type natriuretic peptide (NT-proBNP) were employed as cardiac markers. Frequency of ischemic events (ST segment depression) and left ventricular strain (left ventricular hypertrophy: LVH) were monitored by recording ambulatory 24-h blood pressure (BP), -ECG and 12 lead standard ECG.Results:
Hypertension diagnosed with ambulatory monitoring was more evident in Africans (53.85% vs. 24.59%; p < 0.001) as was the number of ischemic events (6 vs 3; p = 0.006) irrespective of sex. Inflammatory markers (CRP, IL-6 and TNF-α) were significantly higher in Africans, as were Trop T concentrations and degree of LVH (p < 0.05). BP was associated (p < 0.05) with Trop T in all men. In African men, associations were evident between cardiac stress (NT-proBNP), TNF alpha (p < 0.001), Trop T (p < 0.001) and pulse pressure (p = 0.048), adjusted R2 = 0.45.Conclusions:
A risk profile of overload to the heart will increase the susceptibility for cardiac wall remodeling, characterised by hyper- pulsatile pressure, low-grade systemic inflammation and ventricular stress, which may lead to the development of future cardiovascular events in African men.