Correlation analysis of Toll-like receptor 4 signaling pathway molecules and cardiac functions in patients with rheumatic heart disease

  AIM  To explore the correlation between Toll-like receptor 4 (TLR-4) signaling pathway molecules and cardiac functions in patients with rheumatic heart disease.

  METHODS  Selected for study group were 200 patients with rheumatic heart disease admitted to the Department of Cardiovascular Surgery in our hospital from December 2018 to May 2020. According to the New York Heart Association (NYHA) cardiac function grading standard, the patients were divided into NYHA Ⅱ (47 cases), NYHA Ⅲ (96 cases) and NYHA Ⅳ (57 cases). Another 100 patients with normal heart functions who underwent routine physical examination in our hospital were selected as control group. Levels of TLR-4, nuclear factor kappa B (NF-κB) and myeloid differentiation factor (MyD88) protein and left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the groups and the correlation between TLR-4, NF-κB and MyD88 protein levels were analyzed in patients with rheumatic heart disease.

  RESULTS  Compared with those in control group, the levels of TLR-4, NF-κB, MyD88 and LVEDD in study group were significantly higher, while LVEDD was significantly lower (P<0.01). The levels of TLR-4, NF-κB, MyD88 and LVEDD in NYHA Ⅳ patients were significantly higher than those in NYHA Ⅲ and NYHA Ⅱ patients, and the levels in NYHA Ⅲ patients were also significantly higher than those in NYHA Ⅱ patients (P<0.05). The LVEF level in NYHA Ⅳ patients were significantly lower than those in NYHA Ⅲ patients and NYHA Ⅱ patients, and the LVEF level in NYHA Ⅲ patients was also significantly lower than that in NYHA Ⅱ patients (P<0.05). Pearson test found that the levels of TLR-4, NF-κB and MyD88 levels in the peripheral blood of patients with rheumatic heart disease were significantly negatively correlated with the LVEF levels (r=−0.452, −0.321, −0.346, P<0.01), but they were significantly positively correlated with LVEDD levels (r= 0.502, 0.306, 0.491, P<0.01).

  CONCLUSION  The expressions of TLR-4, NF-κB and MyD88 in the peripheral blood of patients with rheumatic heart disease are closely related to the severity of the disease, which can be used as one of the important indicators for evaluating the cardiac functions and prognosis of patients with this disease.