Centre Hospitalier Régional et Universitaire de Lille, Lille Cedex, France.
Eur J Heart Fail. 2011 Dec;13(12):1314-22. doi: 10.1093/eurjhf/hfr137. Epub 2011 Oct 13.
Aim As experimental studies suggest that hepatocyte growth factor (HGF) is cardioprotective after myocardial infarction (MI), this study sought to investigate relationships between circulating levels of HGF and left ventricular (LV) remodelling in patients after acute MI.
This prospective multicentre study included 246 patients with a first anterior Q-wave MI. Serial echocardiographic studies were performed at hospital discharge and 3 and 12 months after MI; quantitative analysis was performed at a core echocardiography laboratory. Blood samples to measure HGF, brain natriuretic peptide (BNP), and C-reactive protein were obtained at discharge and at the 1, 3, and 12 month follow-up visits. Plasma HGF levels were high at baseline, decreased at 1 month, and remained stable thereafter. In the post-MI period (at 3 and 12 months), HGF levels were positively associated with LV volumes, wall motion systolic index, E/Ea, and BNP; and negatively with LV ejection fraction. High HGF levels were associated with higher C-reactive protein levels. Multivariate analysis showed that both BNP (P < 0.0001) and C-reactive protein (P < 0.0001) were independently associated with HGF levels at 3 and 12 months. Patients who died or were rehospitalized for heart failure during follow-up had higher HGF levels at 1 month (P = 0.0006), 3 months (P = 0.018), and 1 year (P = 0.006) after MI.
Circulating HGF levels correlate with all markers of LV remodelling after MI and are associated with rehospitalization for heart failure.
目的 实验研究表明，肝细胞生长因子（HGF）在心肌梗死后具有心脏保护作用，因此本研究旨在探讨急性心肌梗死后患者循环 HGF 水平与左心室（LV）重构之间的关系。
方法和结果 本前瞻性多中心研究纳入了 246 例首次前壁 Q 波心肌梗死患者。在出院时、心肌梗死后 3 个月和 12 个月进行了连续超声心动图研究；在核心超声心动图实验室进行了定量分析。在出院时和 1、3 和 12 个月的随访时采集血样以测量 HGF、脑钠肽（BNP）和 C 反应蛋白。基线时 HGF 水平较高，1 个月时降低，此后保持稳定。在心肌梗死后期间（在 3 个月和 12 个月时），HGF 水平与 LV 容积、室壁运动收缩指数、E/Ea 和 BNP 呈正相关，与 LV 射血分数呈负相关。高 HGF 水平与更高的 C 反应蛋白水平相关。多变量分析显示，BNP（P < 0.0001）和 C 反应蛋白（P < 0.0001）在 3 个月和 12 个月时均与 HGF 水平独立相关。在随访期间因心力衰竭死亡或再次住院的患者，在心肌梗死后 1 个月（P = 0.0006）、3 个月（P = 0.018）和 1 年（P = 0.006）时 HGF 水平更高。
结论 循环 HGF 水平与心肌梗死后所有 LV 重构标志物相关，与因心力衰竭再次住院相关。
