Chlamydia pneumoniae and cytomegalovirus infection and cardiovascular remodeling in hypertensives

Background We investigated infuence of Chlamydia pneumoniae (Ch.p.) and Cytomegalovirus (CMV) infection on cardiovascular remodeling in essential hypertension. Material and methods 112 hypertensives were included in the study (age: 55,7 +/- 12 y, known duration of hypertension 12,7 +/- 8 y). Antibodies against Ch.p, CMV, human HSP60 and ICAM-1, CRP and TNF-alpha levels were assessed. To assess cardiovascular remodeling following investigations were performed: carotid intima-media thickness (IMT), carotid-femoral pulse wave velocity (PWV), left ventricular mass index (LVMI), diastolic function (IVRT - isovolumetric relaxation time, E/A - mitral inflow waves ratio, EDT - E wave deceleration time, AR - reversal flow in pulmonary veins during atrial contraction, S/D pulmonary inflow waves ratio). Results 66 patients (59%) were seropositive for Ch.p., and 86 (77%) for CMV. Ch.p (+) group had higher IMT values (0,84 vs. 0,93 mm, p = 0,001), lower E/A (0,94 vs. 1/03, p = 0,03) and higher CRP level (1,8 vs. 1,37 mg/l, p = = 0,07). After adjusting for age these differences ceased to be significant. CMV (+) group had longer IVRT (96,3 vs. 88,8 ms, p = 0,06), higher PWV (10,5 vs. 9,3 m/s, p = = 0,006), lower E/A (0,93 vs. 1,2, p = 0,0001), higher AR (34,9 vs. 30,7 cm/s, p = 0,007), higher CRP (1,8 vs. 1,17 mg, p = 0,037) and ICAM-1 (269,9 vs. 237,2, p = 0,028) levels. After adjusting for age, BMI and cholesterol only differences in E/A, AR and CRP remained significant. There were several significant weak correlations in univariate and multivariate analysis between antibodies levels and indices of remodeling. Conclusions CMV and Chlamydia pneumoniae infection influences in a small degree both cardiovascular remodeling indices and inflammatory markers in essential hypertensives.