Roselló-Lletí Esther, Rivera Miguel, Miró Vicente, Cortés Raquel, Martínez-Dolz Luís, Portolés Manuel
Unidad de Cardiología, Centro de Investigación del Hospital Universitario La Fe, Valencia, España.
Med Clin (Barc). 2009 Jul 4;133(5):173-6. doi: 10.1016/j.medcli.2008.10.062. Epub 2009 Apr 18.
Several studies have analyzed big endothelin-1 as a marker of mortality in patients with severe heart failure (HF). However, it has not proven prognostic value in patients with moderately symptomatic functional class. Our objective was to evaluate, in a 24 months follow-up, the prognostic power of big endothelin-1 in patients with HF and moderately deteriorated functional class.
Big endothelin-1 levels were measured in a cohort of 90 outpatients (age 64 (13), 70% males) diagnosed with HF. Patients were functionally classified (NYHA).
For the whole population, big endothelin-1 was 0.86 (0.61-1.20)fmol/ml. We evaluated its predictive value in detecting cardiovascular mortality, obtaining an AUC of 0.68 (0.08) (P=.02), and a cut-off value of 0.98 fmol/ml (sensitivity 69%, specificity 75%). When a logistic regression analysis was performed, big endothelin-1 was also an independent predictor of mortality (OR=5.851, P=.009).
Big endothelin-1 predicts cardiovascular mortality in patients diagnosed of HF and moderately symptomatic functional class.
多项研究分析了大内皮素-1作为重度心力衰竭（HF）患者死亡率的标志物。然而，在中度症状功能分级的患者中，它尚未被证明具有预后价值。我们的目的是在24个月的随访中，评估大内皮素-1对HF且功能分级中度恶化患者的预后预测能力。
在90例诊断为HF的门诊患者（年龄64（13）岁，7男性占70%）队列中测量大内皮素-1水平。患者进行功能分级（纽约心脏协会分级））。
对于整个人群，大内皮素-1水平为0.86（0.61 - 1.20）fmol/ml。我们评估了其在检测心血管死亡率方面的预测价值，得到曲线下面积为0.68（0.08）（P = 0.02），临界值为0.98 fmol/ml（敏感性69%，特异性75%）。当进行逻辑回归分析时，大内皮素-1也是死亡率的独立预测因子（比值比=5.851，P = 0.009）。
大内皮素-1可预测诊断为HF且有中度症状功能分级患者的心血管死亡率。
