Kimura Yuichi, Izumiya Yasuhiro, Hanatani Shinsuke, Yamamoto Eiichiro, Kusaka Hiroaki, Tokitsu Takanori, Takashio Seiji, Sakamoto Kenji, Tsujita Kenichi, Tanaka Tomoko, Yamamuro Megumi, Kojima Sunao, Tayama Shinji, Kaikita Koichi, Hokimoto Seiji, Ogawa Hisao
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
Heart Vessels. 2016 Jan;31(1):52-9. doi: 10.1007/s00380-014-0571-y. Epub 2014 Aug 24.
Thrombospondin-2 (TSP-2) is highly expressed in hypertensive heart. Interstitial fibrosis is frequently observed in hypertensive heart, and it is a characteristic feature of heart failure with preserved ejection fraction (HFpEF). We tested here the hypothesis that high TSP-2 serum levels reflect disease severity and can predict poor prognosis of patients with HFpEF. Serum TSP-2 levels were measured by ELISA in 150 patients with HFpEF. HFpEF was defined as left ventricular ejection fraction ≥ 50%, B-type natriuretic peptide (BNP) ≥ 100 pg/ml or E/e' ≥ 15. The endpoints were mortality rate, HF-related hospitalization, stroke and non-fatal myocardial infarction. The median serum TSP-2 level was 19.2 (14.4-26.0) ng/ml. Serum TSP-2 levels were associated with the New York Heart Association (NYHA) functional class. Circulating levels of BNP and high-sensitivity troponin T were positively correlated with serum TSP-2 levels. Kaplan-Meier survival curve showed high risk of adverse cardiovascular events in the high TSP-2 group (>median value), and that the combination of high TSP-2 and high BNP (≥ 100 pg/ml) was associated with the worst event-free survival rate. Multivariate Cox proportional hazard analysis identified TSP-2 as independent predictor of risk of death and cardiovascular events. Circulating TSP-2 correlates with disease severity in patients with HFpEF. TSP-2 is a potentially useful predictor of future adverse cardiovascular events in patients with HFpEF.
血小板反应蛋白-2（TSP-2）在高血压性心脏中高表达。高血压性心脏中常可见间质纤维化，这是射血分数保留的心力衰竭（HFpEF）的一个特征性表现。我们在此检验了这样一个假设，即血清TSP-2水平升高反映疾病严重程度，并可预测HFpEF患者的不良预后。采用酶联免疫吸附测定法（ELISA）检测了150例HFpEF患者的血清TSP-2水平。HFpEF定义为左心室射血分数≥50%、B型利钠肽（BNP）≥100 pg/ml或E/e'≥15。观察终点为死亡率、与心力衰竭相关的住院率、中风和非致命性心肌梗死。血清TSP-2水平的中位数为19.2（14.4 - 26.0）ng/ml。血清TSP-2水平与纽约心脏协会（NYHA）心功能分级相关。BNP和高敏肌钙蛋白T的循环水平与血清TSP-2水平呈正相关。Kaplan-Meier生存曲线显示，TSP-2水平高的组（>中位数）发生不良心血管事件的风险高，且TSP-2水平高与BNP水平高（≥100 pg/ml）的联合情况与最差的无事件生存率相关。多变量Cox比例风险分析确定TSP-2是死亡风险和心血管事件的独立预测因子。循环TSP-2与HFpEF患者的疾病严重程度相关。TSP-2是HFpEF患者未来发生不良心血管事件的一个潜在有用的预测指标。
