Division of Internal Medicine, Hypertension and Cardio-Renal Diseases Centre, Department of Internal Medicine and Systemic Diseases, University of Catania, c/o Ospedale Civile, Ragusa, Italy.
Nephron Clin Pract. 2010;114(1):c74-80. doi: 10.1159/000252806. Epub 2009 Oct 23.
E-selectin is a specific endothelial cell product involved in leukocyte recruitment on the endothelium, which is an important early step in the reparative process following vascular damage. In end-stage renal disease (ESRD), the relationship of E-selectin with left ventricular function has been so far neglected.
We studied 237 patients on chronic dialysis (200 on hemodialysis, 37 on continuous ambulatory peritoneal dialysis) for at least 6 months, without clinical evidence of heart failure. On a mid-week non-dialysis day, fasting blood sampling and echocardiography were performed.
Left ventricular mass index (LVMI, corrected for height) was inversely related to E-selectin levels, increasing from 56.8 +/- 18.9 (>75th percentile E-selectin tertile) to 66.7 +/- 20.1 g/m(2.7) (<50th percentile E-selectin tertile) (p = 0.002). However, in multiple regression models, including traditional (age, sex, smoking, diabetes, systolic blood pressure, hemoglobin, albumin, previous cardiovascular events) and emerging (asymmetric dimethylarginine, interleukin-6) risk factors associated with ESRD, soluble E-selectin has proved to be a significant inverse and independent predictor of mean wall thickness, but not of LVMI.
This study demonstrates that soluble E-selectin is inversely associated with the muscular component of the left ventricle, thereby suggesting that the lack of such a reparative factor may be associated with cardiac remodeling in ESRD patients.
E-选择素是一种特定的内皮细胞产物，参与白细胞在内皮细胞上的募集，这是血管损伤后修复过程的重要早期步骤。在终末期肾病（ESRD）中，E-选择素与左心室功能的关系迄今为止一直被忽视。
我们研究了 237 名至少接受了 6 个月慢性透析（200 名血液透析，37 名持续不卧床腹膜透析）的患者，且没有心力衰竭的临床证据。在非透析日的一周中间，进行空腹采血和超声心动图检查。
左心室质量指数（LVMI，按身高校正）与 E-选择素水平呈负相关，从 56.8 +/- 18.9（> 75 百分位 E-选择素三分位数）增加到 66.7 +/- 20.1 g/m(2.7)（< 50 百分位 E-选择素三分位数）（p = 0.002）。然而，在包括传统（年龄、性别、吸烟、糖尿病、收缩压、血红蛋白、白蛋白、先前心血管事件）和新兴（不对称二甲基精氨酸、白细胞介素-6）与 ESRD 相关的危险因素的多变量回归模型中，可溶性 E-选择素被证明是平均壁厚度的显著负相关和独立预测因子，但不是 LVMI。
这项研究表明，可溶性 E-选择素与左心室的肌肉成分呈负相关，这表明在 ESRD 患者中缺乏这种修复因子可能与心脏重构有关。
