Ayça Burak, Sahin Irfan, Kucuk Suat Hayri, Akin Fatih, Kafadar Didem, Avşar Murat, Avci Ilker Ilhan, Gungor Barış, Okuyan Ertugrul, Dinckal Mustafa Hakan
Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
Department of Biochemistry, Bağcılar Education and Research Hospital, Bağcılar, Istanbul, Turkey.
Clin Cardiol. 2015 Jun;38(6):371-7. doi: 10.1002/clc.22404. Epub 2015 May 14.
Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease characterized by ventricular hypertrophy, myocardial fibrosis, and impaired ventricular relaxation. The exact mechanisms by which fibrosis is caused remain unknown.
Circulating TGF-β is related to poor prognosis in HCM.
We compared TGF-β levels of 49 HCM patients with those of 40 non-HCM patients. We followed the patients with HCM for 18 months and divided them into 2 groups: low TGF-β (≤ 4877 pg/mL) and high TGF-β (> 4877 pg/mL). We compared the 2 groups in terms of brain natriuretic peptide (BNP), echocardiographic parameters, and clinical outcomes including myocardial infarction, arrhythmias, implantable cardioverter-defibrillator implantation, hospitalization, New York Heart Association (NYHA) class, acute heart failure, and mortality.
The HCM patients had higher TGF-β levels than those in the control group (P = 0.005). In the follow-up, those in the high TGF-β group had higher BNP levels, larger left-atrial size, thicker interventricular septum, NYHA class, more hospitalizations, and a greater number of clinical adverse events (P < 0.001, P = 0.01, P < 0.001, P = 0.002, P < 0.001 and P = 0.003, respectively). TGF-β level of > 4877 pg/mL can predict adverse events with a specificity of 75% and a sensitivity of 72% (P = 0.014). In multivariate regression analysis, TGF-β, BNP, and interventricular septum thickness were significantly associated with adverse events (P = 0.028, P = 0.030, and P = 0.034, respectively).
The TGF-β level is higher in HCM patients and associated with a poor prognosis in HCM.
肥厚型心肌病（HCM）是一种常见的遗传性心脏病，其特征为心室肥厚、心肌纤维化和心室舒张功能受损。导致纤维化的确切机制尚不清楚。
循环中的转化生长因子-β（TGF-β）与HCM患者的不良预后相关。
我们比较了49例HCM患者与40例非HCM患者的TGF-β水平。我们对HCM患者进行了18个月的随访，并将他们分为两组：低TGF-β组（≤4877 pg/mL）和高TGF-β组（>4877 pg/mL）。我们比较了两组患者的脑钠肽（BNP）、超声心动图参数以及包括心肌梗死、心律失常、植入式心脏复律除颤器植入、住院、纽约心脏协会（NYHA）心功能分级、急性心力衰竭和死亡率在内的临床结局。
HCM患者的TGF-β水平高于对照组（P = 0.005）。在随访中，高TGF-β组患者的BNP水平更高、左心房内径更大、室间隔更厚、NYHA心功能分级更高、住院次数更多以及临床不良事件数量更多（分别为P < 0.001、P = 0.01、P < 0.001、P = 0.002、P < 0.001和P = 0.003）。TGF-β水平>4877 pg/mL可预测不良事件，特异性为75%，敏感性为72%（P = 0.014）。在多因素回归分析中，TGF-β、BNP和室间隔厚度与不良事件显著相关（分别为P = 0.028、P = 0.030和P = 0.034）。
HCM患者的TGF-β水平较高，且与HCM患者的不良预后相关。
