血清肌钙蛋白 I、CK-MB 和肌红蛋白浓度对特发性扩张型心肌病患者的预后评估。
The prognostic use of serum concentrations of cardiac troponin-I, CK-MB and myoglobin in patients with idiopathic dilated cardiomyopathy.
机构信息
Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China; Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
The Center of Heart Development, Key Lab of MOE for Development Biology and Protein Chemistry, College of Life Science, Hunan Normal University, Changsha, Hunan 410081, China.
出版信息
Heart Lung. 2014 May-Jun;43(3):219-24. doi: 10.1016/j.hrtlng.2014.03.001.
OBJECTIVE
To examine the association between survival and serum concentrations of cTnI, CK-MB, and myoglobin in patients with idiopathic dilated cardiomyopathy (IDC).
BACKGROUND
It has been suggested that elevated circulating biomarkers of myocardial damage such as cardiac troponin-I (cTnI), creatine kinase MB (CK-MB) and myoglobin are independent risk factors for mortality in patients with heart failure, and recent studies, although limited, showed that there was a potential association between cTnI and the prognosis of patients with dilated cardiomyopathy (DCM).
METHODS
A cohort study was undertaken in 310 patients with IDC. Standard demographic information, transthoracic echocardiography, and routine blood tests were obtained shortly after hospital admission. Outcome was assessed with all-cause mortality.
RESULTS
Among the 310 patients studied, 61 (19.7%) died during a mean follow-up of 2.2 years. There was a significant difference in the all-cause mortality rate between patients with serum cTnI >0.05 ng/mL and with cTnI ≤ 0.05 ng/mL (37.5% vs 15%, log-rank χ(2) = 18.423, P < 0.001). After adjustment for other factors associated with prognosis at baseline, serum cTnI >0.05 ng/mL, QRS duration, NYHA functional class and systolic blood pressure predicted all-cause mortality in patients with IDC. There was no association between circulating CK-MB and myoglobin levels and all-cause mortality in the studied IDC patients.
CONCLUSION
Serum concentrations of cTnI but not CK-MB or myoglobin are an independent predictor of all-cause mortality in patients with IDC.
目的
探讨血清肌钙蛋白 I（cTnI）、肌酸激酶同工酶 MB（CK-MB）和肌红蛋白浓度与特发性扩张型心肌病（IDC）患者生存的关系。
背景
已有研究表明，循环心肌损伤生物标志物如心脏肌钙蛋白 I（cTnI）、肌酸激酶同工酶 MB（CK-MB）和肌红蛋白水平升高是心力衰竭患者死亡的独立危险因素，尽管最近的研究有限，但表明 cTnI 与扩张型心肌病（DCM）患者的预后之间存在潜在关联。
方法
对 310 例 IDC 患者进行了队列研究。患者入院后不久即采集标准人口统计学信息、经胸超声心动图和常规血液检查。通过全因死亡率评估预后。
结果
在 310 例研究患者中，61 例（19.7%）在平均 2.2 年的随访期间死亡。cTnI＞0.05ng/mL 与 cTnI≤0.05ng/mL 的患者全因死亡率之间存在显著差异（37.5%比 15%，log-rank χ(2)=18.423，P＜0.001）。在校正基线时与预后相关的其他因素后，cTnI＞0.05ng/mL、QRS 持续时间、NYHA 心功能分级和收缩压可预测 IDC 患者的全因死亡率。在研究的 IDC 患者中，循环 CK-MB 和肌红蛋白水平与全因死亡率之间无关联。
结论
血清 cTnI 浓度而非 CK-MB 或肌红蛋白是 IDC 患者全因死亡率的独立预测因子。
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