Milting Hendrik, Ellinghaus Peter, Seewald Michael, Cakar Hamdin, Bohms Birte, Kassner Astrid, Körfer Reiner, Klein Martina, Krahn Thomas, Kruska Lothar, El Banayosy Aly, Kramer Frank
Herz- und Diabeteszentrum NRW, Erich und Hanna Klessmann Institut für Kardiovaskuläre Forschung und Entwicklung, Bad Oeynhausen, Germany.
J Heart Lung Transplant. 2008 Jun;27(6):589-96. doi: 10.1016/j.healun.2008.02.018.
In this study we analyzed putative biomarkers for myocardial remodeling in plasma from 55 endstage heart failure patients with the need for mechanical circulatory support (MCS). We compared our data to 40 healthy controls and examined if MCS by either ventricular assist devices or total artificial hearts has an impact on plasma concentrations of remodeling biomarkers.
METHODS & RESULTS: Plasma biomarkers were analysed pre and 30 days post implantation of a MCS device using commercially available enzyme linked immunosorbent assays (ELISA). We observed that the plasma concentrations of remodeling biomarkers: tissue inhibitor of metalloproteinase 1 (TIMP1), tenascin C (TNC), galectin 3 (LGALS3), osteopontin (OPN) and of neurohumoral biomarker brain natriuretic peptide (BNP), are significantly elevated in patients with terminal heart failure compared to healthy controls. We did not find elevated plasma concentrations for matrix metalloproteinase 2 (MMP2) and procollagen I C-terminal peptide (PCIP). However, only BNP plasma levels were reduced by MCS, whereas the concentrations of remodeling biomarkers remained elevated or even increased further 30 days after MCS. LGALS3 plasma concentrations at device implantation were significantly higher in patients who did not survive MCS due to multi organ failure (MOF).
Our findings indicate that mechanical unloading in endstage heart failure is not reflected by a rapid reduction of remodeling plasma biomarkers.
在本研究中，我们分析了55例需要机械循环支持（MCS）的终末期心力衰竭患者血浆中的心肌重塑假定生物标志物。我们将我们的数据与40名健康对照者的数据进行了比较，并研究了心室辅助装置或全人工心脏进行的MCS是否会对重塑生物标志物的血浆浓度产生影响。
使用市售酶联免疫吸附测定（ELISA）在植入MCS装置前和植入后30天分析血浆生物标志物。我们观察到，与健康对照者相比，终末期心力衰竭患者中重塑生物标志物：金属蛋白酶组织抑制剂1（TIMP1）、腱生蛋白C（TNC）、半乳糖凝集素3（LGALS3）、骨桥蛋白（OPN）以及神经体液生物标志物脑钠肽（BNP）的血浆浓度显著升高。我们未发现基质金属蛋白酶2（MMP2）和前胶原I C末端肽（PCIP）的血浆浓度升高。然而，只有BNP的血浆水平因MCS而降低，而重塑生物标志物的浓度在MCS后30天仍保持升高甚至进一步升高。因多器官衰竭（MOF）而未在MCS中存活的患者在装置植入时的LGALS3血浆浓度显著更高。
我们的研究结果表明，终末期心力衰竭中的机械卸载并未通过重塑血浆生物标志物的快速降低反映出来。
