In active juvenile dermatomyositis, elevated eotaxin and MCP-1 and cholesterol levels in the upper normal range are associated with cardiac dysfunction.

Abstract

The aim of this study was to examine the influence of chemokines and lipids on cardiac function in patients with active and inactive JDM and matched controls. Fifty-four JDM patients were clinically examined a median 16.8 years (range 2-38) after disease onset and compared with 54 sex- and age-matched controls. Inactive disease was defined by the PRINTO criteria. Serum levels of chemokines were analysed by Luminex technology. Echocardiography was performed and analysed blinded to patient information. Long-axis strain and e' were used as parameters of systolic and diastolic function, respectively. In patients, but not in controls, eotaxin and monocyte chemoattractant protein 1 (MCP-1) correlated with systolic (r = -0.65 and r = -0.45) and diastolic (r = -0.59 and r = -0.65) function, particularly in those with active disease (systolic function, r = -0.74 and r = -0.60; diastolic function, r = -0.69 and r = -0.80). Total cholesterol level was lower in patients than controls [mean 4.19 mmol/l (s.d. 0.82) vs 4.60 (0.87), P ≤ 0.01]. However, total cholesterol levels in the upper normal range were associated with systolic (r = -0.56, P < 0.01) and diastolic (r = -0.64, P < 0.001) dysfunction and with high eotaxin and MCP-1 (r = 0.56 and r = 0.50, P < 0.01) in patients with active disease, but not in those with inactive disease or in controls (all r < ±0.2). In the active disease state of JDM, eotaxin and MCP-1 were associated with cardiac dysfunction, possibly through sustained inflammation. In those with active disease and cholesterol levels in the upper normal range, eotaxin and MCP-1 might enhance susceptibility to cardiac dysfunction.