血浆心钠素水平与可溶性Fas之间的关系：血浆可溶性Fas作为充血性心力衰竭患者的预后预测指标

Relationship between plasma levels of cardiac natriuretic peptides and soluble Fas: plasma soluble Fas as a prognostic predictor in patients with congestive heart failure.

作者信息

Tsutamoto T, Wada A, Maeda K, Mabuchi N, Hayashi M, Tsutsui T, Ohnishi M, Fujii M, Matsumoto T, Yamamoto T, Takayama T, Kinoshita M

机构信息

First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Japan.

出版信息

J Card Fail. 2001 Dec;7(4):322-8. doi: 10.1054/jcaf.2001.30134.

DOI:10.1054/jcaf.2001.30134

PMID:11782855

Abstract

BACKGROUND

Cardiac natriuretic peptides may induce apoptosis in myocytes; however, the relationship between plasma levels of cardiac natriuretic peptides and those of soluble Fas (sFas) and tumor necrosis factor (TNF)-alpha remains unknown in patients with congestive heart failure (CHF).

METHODS AND RESULTS

We measured plasma levels of sFas and TNF-alpha and those of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), norepinephrine, and endothelin 1 in 96 patients with CHF (ejection fraction < 45%). The patients were monitored for 3 years. Plasma levels of sFas and TNF-alpha increased with the severity of CHF. There was no significant correlation between sFas plasma levels and those of ANP and BNP. Cox proportional hazard analysis showed that high levels of sFas (P = .009) and BNP (P < .0001) and a low ejection fraction (P = .019) were independent significant prognostic predictors.

CONCLUSIONS

There is no significant correlation between cardiac natriuretic peptide and sFas levels in plasma. Plasma sFas is a useful prognostic marker independent of neurohumoral factors, suggesting that immune activation and/or apoptosis play a significant role in the pathogenesis of CHF.

摘要

背景

心脏利钠肽可能诱导心肌细胞凋亡；然而，在充血性心力衰竭（CHF）患者中，血浆心脏利钠肽水平与可溶性Fas（sFas）及肿瘤坏死因子（TNF）-α水平之间的关系尚不清楚。

方法与结果

我们测定了96例CHF患者（射血分数<45%）的血浆sFas、TNF-α、心房利钠肽（ANP）、脑利钠肽（BNP）、去甲肾上腺素和内皮素1水平。对患者进行了3年的监测。血浆sFas和TNF-α水平随CHF严重程度增加而升高。sFas血浆水平与ANP和BNP水平之间无显著相关性。Cox比例风险分析显示，高水平的sFas（P = .009）、BNP（P < .0001）和低射血分数（P = .019）是独立的显著预后预测指标。