title: In active juvenile dermatomyositis, elevated eotaxin and MCP-1 and cholesterol levels in the upper normal range are associated with cardiac dysfunction.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway thomas.schwartz@medisin.uio.no.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwartz
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Ivar
authors.initials: I
authors.lastname: Sjaastad
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Flatø
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Vistnes
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Christensen
authors.affiliation: Institute for Experimental Medical Research, Oslo University Hospital-Ullevål, KG Jebsen Cardiac Research Center and Center for Heart Failure Research, Institute for Clinical Medicine, University of Oslo, Department of Cardiology, Oslo University Hospital-Ullevål and Section of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Helga
authors.initials: H
authors.lastname: Sanner
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D016022:Case-Control Studies; D054413:Chemokine CCL11 / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood; D018925:Chemokines / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D003882:Dermatomyositis / Q000097:blood* / Q000150:complications; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D055815:Young Adult
chemical_list: D015415:Biomarkers; C515456:CCL11 protein, human; C111835:CCL2 protein, human; D054413:Chemokine CCL11; D018932:Chemokine CCL2; D018925:Chemokines; D002784:Cholesterol
keywords: cardiovascular; cytokines and inflammatory mediators; myositis and muscle disease; paediatric/juvenile rheumatology; vasculitis