Third Department of Internal Medicine, Semmelweis University, 1125, Budapest, Kútvölgyi út 4, Hungary,
Cell Stress Chaperones. 2013 Nov;18(6):809-13. doi: 10.1007/s12192-013-0425-z. Epub 2013 Apr 7.
Predicting the survival of a patient with heart failure (HF) is a complex problem in clinical practice. Our previous study reported that extracellular HSP70 (HSPA1A) correlates with markers of heart function and disease severity in HF, but the predictive value of HSP70 is unclear. The goal of this study was to analyze extracellular HSP70 as predictive marker of mortality in HF. One hundred ninety-five patients with systolic heart failure were enrolled and followed up for 60 months. By the end of follow-up, 85 patients were alive (survivors) and 110 died (nonsurvivors). HSP70 (measured by ELISA in the serum) was elevated in nonsurvivors, compared with survivors (0.39 [0.27-0.59] vs. 0.30 [0.24-0.43] ng/ml, respectively, p = 0.0101). In Kaplan-Meier survival analysis higher HSP70 levels above median were associated with a significantly increased mortality. In multivariable survival models, we show that HSP70 level above the median is an age-, sex-, body mass index-, creatinine-, and NT-proBNP-independent predictor of 5-year mortality in HF. Extracellular HSP70 could prove useful for estimating survival in patients with HF.
预测心力衰竭（HF）患者的生存情况是临床实践中的一个复杂问题。我们之前的研究报告称，细胞外热休克蛋白 70（HSPA1A）与 HF 中心功能和疾病严重程度的标志物相关，但 HSP70 的预测价值尚不清楚。本研究的目的是分析细胞外 HSP70 作为 HF 患者死亡率的预测标志物。共纳入 195 例收缩性心力衰竭患者，并进行了 60 个月的随访。随访结束时，85 例患者存活（幸存者），110 例死亡（非幸存者）。与幸存者相比，非幸存者的 HSP70（通过 ELISA 在血清中测量）升高（分别为 0.39[0.27-0.59]和 0.30[0.24-0.43]ng/ml，p=0.0101）。在 Kaplan-Meier 生存分析中，HSP70 水平高于中位数与死亡率显著增加相关。在多变量生存模型中，我们表明 HSP70 水平高于中位数是 HF 患者 5 年死亡率的独立预测因子，与年龄、性别、体重指数、肌酐和 NT-proBNP 无关。细胞外 HSP70 可能有助于估计 HF 患者的生存情况。
