Department of Cardiovascular Medicine, the Cleveland Clinic, Cleveland, Ohio 44195, USA.
J Card Fail. 2010 Aug;16(8):621-7. doi: 10.1016/j.cardfail.2010.03.010. Epub 2010 May 4.
Corin is a serine protease that cleaves pro-atrial and pro-B-type natriuretic peptides into biologically active hormones. The relationship between soluble plasma corin levels, plasma natriuretic peptide levels, myocardial structure and performance, and long-term clinical outcomes in the setting of chronic systolic heart failure has not been described.
In 126 patients with chronic systolic heart failure (left ventricular ejection fraction <or=35%, New York Heart Association functional Class I-IV), we measured plasma corin and natriuretic peptide levels and performed comprehensive echocardiography with assessment of cardiac structure and performance. Adverse clinical events (all-cause mortality, cardiac transplantation, or heart failure hospitalization) were prospectively tracked for a median of 38 months. Plasma corin levels modestly correlated with echocardiographic indices of cardiac structure, including left ventricular mass index (r = 0.30, P = .003) and interventricular septum width (r = 0.22, P = .013). However, plasma corin levels did not correlate with age, arterial pressures, estimated glomerular filtration rate, echocardiographic indices of systolic or diastolic function, or plasma natriuretic peptide levels. In Cox proportional hazards analysis, higher plasma corin levels did not predict reduced risk of adverse clinical events (hazard ratio 0.91; 95% confidence interval 0.67-1.24, P = .52), and did not provide incremental prognostic value to natriuretic peptide levels.
In our cohort of ambulatory patients with chronic systolic heart failure, soluble plasma corin levels did not provide prognostic utility incremental to that of natriuretic peptides.
Corin 是一种丝氨酸蛋白酶，可将前房肽和 B 型利钠肽原切割成具有生物活性的激素。在慢性收缩性心力衰竭的情况下，可溶性血浆 Corin 水平与血浆利钠肽水平、心肌结构和功能以及长期临床结局之间的关系尚未被描述。
在 126 例慢性收缩性心力衰竭患者（左心室射血分数≤35%，纽约心脏协会功能分级 I-IV 级）中，我们测量了血浆 Corin 和利钠肽水平，并进行了全面的超声心动图检查，评估了心脏结构和功能。前瞻性地跟踪了 126 例患者 38 个月的不良临床事件（全因死亡率、心脏移植或心力衰竭住院）。血浆 Corin 水平与心脏结构的超声心动图指标呈中度相关，包括左心室质量指数（r = 0.30，P =.003）和室间隔宽度（r = 0.22，P =.013）。然而，血浆 Corin 水平与年龄、动脉压、估计肾小球滤过率、收缩或舒张功能的超声心动图指数或血浆利钠肽水平均无相关性。在 Cox 比例风险分析中，较高的血浆 Corin 水平并不能预测不良临床事件风险降低（风险比 0.91；95%置信区间 0.67-1.24，P =.52），并且不能为利钠肽水平提供额外的预后价值。
在我们的慢性收缩性心力衰竭门诊患者队列中，可溶性血浆 Corin 水平不能提供比利钠肽水平更有预后价值的信息。
