Limongelli Giuseppe, Roselli Teo, Pacileo Giuseppe, Calabró Paolo, Maddaloni Valeria, Masarone Daniele, Riegler Lucia, Gravino Rita, Scarafile Raffaella, Salerno Gemma, Miele Tiziana, D'Andrea Antonello, Santangelo Lucio, Romano Massimo, Di Salvo Giovanni, Russo Maria Giovanna, Calabró Raffaele
Department of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy,
Intern Emerg Med. 2014 Feb;9(1):43-50. doi: 10.1007/s11739-011-0740-2. Epub 2011 Dec 17.
Cardiotrophin-1 (CT-1) is a member of the interleukin (IL-6) family of cytokines. Plasma CT-1 levels correlate with the left ventricle mass index in patients with dilatated cardiomyopathy and congestive heart failure (CHF). The aim of this paper was to evaluate CT-1 plasma levels, before and after cardiac resynchronization therapy CRT, and to characterizeits prognostic role in patients with CHF. Fifty-two consecutive patients (M/F = 39/13; 56 ± 11 years old) underwent clinical and echocardiographic evaluation, and blood sample collection at baseline. The same evaluation was repeated 6.4 ± 0.79 months after CRT. Patients with a decreased LV end-systolic volume by at least 15% (reverse remodeling) were considered echo responders to CRT. Twenty-nine patients (56%) were responders to CRT. After CRT, only 15 patients (29%) showed increased CT-1 after CRT. They were all non responders to CRT. A multivariate, logistic model showed CT-1 as an independent predictor of CRT echo response (p = 0.005; OR 0.97). During follow-up (18 ± 7 months), 21 cardiac events in 18 patients occurred. A Cox multivariable model showed plasma BNP pre-CRT (p = 0.02; CI 1.2-5.6; OR 3.1) and CT1 post-CRT (p = 0.01; CI 1.4-4.3; OR 2.7) as independent predictors of cardiac events. Analysis of CT-1 plasma levels deserves future consideration for larger, longitudinal studies in patients with CHF.
心肌营养素-1（CT-1）是细胞因子白细胞介素（IL-6）家族的成员。在扩张型心肌病和充血性心力衰竭（CHF）患者中，血浆CT-1水平与左心室质量指数相关。本文旨在评估心脏再同步治疗（CRT）前后的CT-1血浆水平，并确定其在CHF患者中的预后作用。连续52例患者（男/女=39/13；56±11岁）在基线时接受了临床和超声心动图评估，并采集了血样。在CRT后6.4±0.79个月重复进行相同评估。左心室收缩末期容积至少减少15%（逆向重构）的患者被视为CRT的超声心动图反应者。29例患者（56%）对CRT有反应。CRT后，只有15例患者（29%）的CT-1水平在CRT后升高。他们均对CRT无反应。多变量逻辑模型显示CT-1是CRT超声心动图反应的独立预测因子（p=0.005；OR 0.97）。在随访期间（18±7个月），18例患者发生了21次心脏事件。Cox多变量模型显示，CRT前的血浆脑钠肽（p=0.02；CI 1.2-5.6；OR 3.1）和CRT后的CT1（p=0.01；CI 1.4-4.3；OR 2.7）是心脏事件的独立预测因子。对于CHF患者进行更大规模的纵向研究，CT-1血浆水平分析值得未来关注。
