Yıldırım Erkan, Cengiz Mahir, Yıldırım Nilgün, Aslan Kürşat, İpek Emrah, Korkmaz Ali Fuat, Ulusoy Fatih Rıfat, Hatem Engin
Clinic of Cardiology, Erzurum Research and Training Hospital; Erzurum-Turkey.
Anatol J Cardiol. 2017 Mar;17(3):184-190. doi: 10.5152/akd.2014.5793. Epub 2014 Dec 25.
Urocortin 1 (UCN1) has vasodilator, diuretic, and natriuretic effects, and its expression increases in heart failure (HF). Adrenomedullin (ADM) increases cardiac output and lowers blood pressure in healthy men and in patients with heart failure. The aim of the study was to determine UCN1 and ADM levels in patients with HF, to evaluate the relationship of UCN1 and ADM with various clinical parameters, and to assess UCN1 and ADM as diagnostic markers in HF, in comparison with pro-brain natriuretic peptide (pro-BNP).
We investigated serum levels of UCN1, ADM, and pro BNP in 86 consecutive patients with systolic HF [ejection fraction (EF) ≤45%] and 85 healthy controls. Serum UCN1, ADM, and pro-BNP levels were measured with the ELISA method. Transthoracic echocardiography was performed to determine left ventricular EF and pulmonary artery systolic pressure.
UCN1 and ADM levels were higher in HF patients (446.2±145.7 pg/mL, p<0.001; 87.9±4.2 pg/mL, p<0.001 respectively). UCN1 was positively correlated with pro-BNP (r=0.963, p<0.001), ADM (r=0.915, p<0.001), and NYHA (r=0.879, p<0.001); ADM was positively correlated with pro-BNP (r=0.956, p<0.001) and NYHA (r=0.944, p<0.001). Receiver operating characteristic curves yielded an area under the curve of 1.00 (p<0.001) for UCN1, 1.00 (p<0.001) for ADM, and 0.99 (p<0.001) for pro-BNP in the diagnosis of HF.
UCN1 and ADM increase with worsening HF and left ventricular dysfunction. They may be used as diagnostic biomarkers in systolic HF, but the incremental value of measuring UCN1 and ADM in patients tested for pro-BNP is questionable.
尿皮质素1（UCN1）具有血管舒张、利尿和利钠作用，其表达在心力衰竭（HF）时增加。肾上腺髓质素（ADM）可增加健康男性和心力衰竭患者的心输出量并降低血压。本研究的目的是测定HF患者的UCN1和ADM水平，评估UCN1和ADM与各种临床参数的关系，并与脑钠肽前体（pro-BNP）比较，评估UCN1和ADM作为HF诊断标志物的价值。
我们调查了86例连续性收缩性HF患者[射血分数（EF）≤45%]和85例健康对照者的血清UCN1、ADM和pro-BNP水平。采用酶联免疫吸附测定（ELISA）法检测血清UCN1、ADM和pro-BNP水平。进行经胸超声心动图检查以测定左心室EF和肺动脉收缩压。
HF患者的UCN1和ADM水平较高（分别为446.2±145.7 pg/mL，p<0.001；87.9±4.2 pg/mL，p<0.001）。UCN1与pro-BNP（r=0.963，p<0.001）、ADM（r=0.915，p<0.001）和纽约心脏协会（NYHA）分级（r=0.879，p<0.001）呈正相关；ADM与pro-BNP（r=0.956，p<0.001）和NYHA分级（r=0.944，p<0.001）呈正相关。在HF诊断中，UCN1的受试者工作特征曲线下面积为1.00（p<0.001），ADM为1.00（p<0.001），pro-BNP为0.99（p<0.001）。
UCN1和ADM随着HF加重及左心室功能障碍而升高。它们可作为收缩性HF的诊断生物标志物，但在已检测pro-BNP的患者中测定UCN1和ADM的增量价值值得怀疑。
