Influence of ivabradine on expressions of peripheral blood mononuclear Toll-like receptor 4 and nuclear factor-κB in patients with chronic heart failure

Chen Yu; Guo Sizhu; Fan Xing

doi:10.3969/j.issn.1674-4055.2024.11.15

Abstract：Objective To investigate the influence of ivabradine on expressions of peripheral blood mononuclear Toll-like receptor 4(TLR4)and nuclear factor-κ B(NF-κ B)in patients with chronic heart failure(CHF).Methods CHF patients(n=120)were chosen and divided,according to random digital table,into control group and test group(each n=60)in Department of Cardiology in the Third People's Hospital of Chengdu City from Jan.2020 to Jan.2023.The control group were treated with metoprolol on the base of routine therapy,and test group was treated additionally with ivabradine for 3 months.The indexes of heart function,including left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular diastolic diameter(LVDD),6-minute walk distance(6MWD),and serum inflammatory factors including N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin T(cTnT)and matrix metalloproteinase-9(MMP-9),and mRNA expressions of TLR-4 and NF-κB were compared between 2 groups before and after treatment.The clinical curative effect and incidence rates of adverse reactions were compared between 2 groups.Results There were no statistical differences in clinical indexes between 2 groups before treatment(P＞0.05).After treatment,LVEF and 6MWD increased in 2 groups(P＜0.05),and were higher in test group than those in control group(P＜0.05).After treatment,LVESD and LVEDD decreased in 2 groups(P＜0.05),and were lower in test group than those in control group(P＜0.05).There were no statistical differences in serum inflammatory factors between 2 groups before treatment(P＞0.05).After treatment,NT-proBNP,cTnT and MMP-9 decreased in 2 groups(P＜0.05),and were lower in test group than those in control group(P＜0.05).There were no statistical differences in mRNA and protein expressions of TLR-4 and NF-κB between 2 groups before treatment(P＞0.05).After treatment,mRNA and protein expressions of TLR-4 and NF-K B decreased in 2 groups(P＜0.05),and were lower in test group than those in control group(P＜0.05).The total effective rate was higher in test group than that in control group(P＜0.05),and incidence rates of adverse reactions had no statistical difference between 2 groups(P＞0.05).Conclusion Ivabradine can reduce expressions of TLR-4 and NF-κB,effectively improve heart function,decease level of serum inflammatory factors in treatment of CHF,which is an effective medicine for CHF.