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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2023

Open Access 01-12-2023 | Heart Failure | Research

Reduced numbers of regulatory T cells in chronic heart failure seems not to be restored by cardiac resynchronization therapy

Authors: Sílvia Martins, Natália António, Tiago Carvalheiro, Paula Laranjeira, Ricardo Rodrigues, Lino Gonçalves, Cândida Tomaz, Artur Paiva

Published in: BMC Cardiovascular Disorders | Issue 1/2023

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Abstract

Background

T cells have been implicated in the development and progression of inflammatory processes in chronic heart failure (CHF). Cardiac resynchronization therapy (CRT) has beneficial effects on symptoms and cardiac remodeling in CHF. However, its impact on the inflammatory immune response remains controversial. We aimed to study the impact of CRT on T cells in heart failure (HF) patients.

Methods

Thirty-nine HF patients were evaluated before CRT (T0) and six months later (T6). Quantification of T cells, their subsets, and their functional characterization, after in vitro stimulation, were evaluated by flow cytometry.

Results

T regulatory (Treg) cells were decreased in CHF patients (healthy group (HG): 1.08 ± 0.50 versus (heart failure patients (HFP)-T0: 0.69 ± 0.40, P = 0.022) and remaining diminished after CRT (HFP-T6: 0.61 ± 0.29, P = 0.003). Responders (R) to CRT presented a higher frequency of T cytotoxic (Tc) cells producing IL-2 at T0 compared with non-responders (NR) (R: 36.52 ± 12.55 versus NR: 24.71 ± 11.66, P = 0.006). After CRT, HF patients presented a higher percentage of Tc cells expressing TNF-α and IFN-γ (HG: 44.50 ± 16.62 versus R: 61.47 ± 20.54, P = 0.014; and HG: 40.62 ± 15.36 versus R: 52.39 ± 18.66, P = 0.049, respectively).

Conclusion

The dynamic of different functional T cell subpopulations is significantly altered in CHF, which results in an exacerbated pro-inflammatory response. Even after CRT, it seems that the inflammatory condition underlying CHF continues to evolve with the progression of the disease. This could be due, at least in part, to the inability to restore Treg cells levels.
Trial registration: Observational and prospective study with no trial registration.
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Metadata
Title
Reduced numbers of regulatory T cells in chronic heart failure seems not to be restored by cardiac resynchronization therapy
Authors
Sílvia Martins
Natália António
Tiago Carvalheiro
Paula Laranjeira
Ricardo Rodrigues
Lino Gonçalves
Cândida Tomaz
Artur Paiva
Publication date
01-12-2023

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