循环中的心肌蛋白水平可预测充血性心力衰竭未来的病情恶化。

Circulating levels of myocardial proteins predict future deterioration of congestive heart failure.

作者信息

Sugiura Tomonori, Takase Hiroyuki, Toriyama Takayuki, Goto Takatoshi, Ueda Ryuzo, Dohi Yasuaki

机构信息

Department of Internal Medicine, Enshu General Hospital, Hamamatsu, Shizuoka, Japan.

出版信息

J Card Fail. 2005 Sep;11(7):504-9. doi: 10.1016/j.cardfail.2005.04.025.

DOI:10.1016/j.cardfail.2005.04.025

PMID:16198245

Abstract

BACKGROUND

This study was designed to test whether circulating levels of myocardium-specific proteins serve as useful markers for the prognosis of patients with congestive heart failure.

METHODS AND RESULTS

Seventy-eight patients with congestive heart failure from dilated cardiomyopathy but in a stable condition were enrolled, and their blood was sampled for measurements of myosin light chain-I (MLC-I), troponin T (TnT), heart fatty-acid-binding protein (H-FABP), and creatine kinase isoenzyme MB (CK-MB). The patients were then followed up for 951 +/- 68 days, with the endpoint being acute deterioration. A univariate analysis revealed that MLC-I, TnT, H-FABP, and CK-MB were significant predictors for acute deterioration of heart failure. Application of the Kaplan-Meier method using cutoff values determined by analysis of receiver operating characteristics curves demonstrated that the incidence of acute deterioration was significantly higher in patients with higher values of MLC-I (61.9%), TnT (52.4%), H-FABP (50.0%), or CK-MB (38.6%) than in those with lower values of these markers (15.8%, 20.4%, 13.6%, and 16.1%, respectively).

CONCLUSIONS

Increased circulating levels of the specific myocardial proteins are related to a higher probability of future acute deterioration of congestive heart failure in patients in a stable condition associated with dilated cardiomyopathy.

摘要

背景

本研究旨在测试循环中心肌特异性蛋白水平是否可作为充血性心力衰竭患者预后的有用标志物。

方法与结果

纳入78例扩张型心肌病所致充血性心力衰竭且病情稳定的患者，采集其血液以检测肌球蛋白轻链-I（MLC-I）、肌钙蛋白T（TnT）、心脏脂肪酸结合蛋白（H-FABP）和肌酸激酶同工酶MB（CK-MB）。随后对患者进行951±68天的随访，终点为急性病情恶化。单因素分析显示，MLC-I、TnT、H-FABP和CK-MB是心力衰竭急性恶化的显著预测指标。应用通过分析受试者工作特征曲线确定的临界值进行Kaplan-Meier法分析，结果表明，MLC-I（61.9%）、TnT（52.4%）、H-FABP（50.0%）或CK-MB（38.6%）水平较高的患者急性恶化发生率显著高于这些标志物水平较低的患者（分别为15.8%、20.4%、13.6%和16.1%）。