Takashio Seiji, Sugiyama Seigo, Yamamuro Megumi, Takahama Hiroyuki, Hayashi Tomohiro, Sugano Yasuo, Izumiya Yasuhiro, Hokimoto Seiji, Minamino Naoto, Yasuda Satoshi, Anzai Toshihisa, Ogawa Hisao
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
Am J Cardiol. 2015 Jul 15;116(2):243-9. doi: 10.1016/j.amjcard.2015.04.018. Epub 2015 Apr 18.
Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family, which regulates neuronal differentiation and functions. Low levels of BDNF are because of psychological stress and potentially play a role in the pathogenesis of depression and cognition disorders. Because psychological stress and depression are associated with increased risk of heart failure (HF), the pathogenic link between HF and psychological status has attracted clinical attention. We hypothesized that plasma BDNF levels might be decreased in patients with HF and that BDNF could be a key factor associated with HF. We evaluated plasma BDNF levels in 242 patients with HF and 80 subjects without HF who are age and gender matched. Plasma BDNF levels were significantly lower in patients with HF (3,712 pg/ml [2,124 to 6,180]) than those without HF (7,247 pg/ml [5,388 to 9,255], p <0.001) and lower in patients with HF with the New York Heart Association functional class III than class I (p = 0.01) and class II (p <0.001). Log BDNF levels correlated negatively with log B-type natriuretic peptide (r = -0.203, p = 0.03) in patients with HF. Of 61 acute decompensated patients with HF, plasma BDNF levels were significantly higher at discharge (4,194 pg/ml [2,356 to 6,916]) compared with those at admission (2,749 pg/ml [1,380 to 4,161], p = 0.003). Multivariate logistic regression analysis identified log BDNF level as a significant correlate with the presence of HF (odds ratio 0.82; 95% confidence interval 0.76 to 0.91, p <0.001). In conclusion, plasma BDNF levels were decreased in patients with HF and associated with HF severity. BDNF could be a potentially clinically useful biomarker of HF reflecting possible cardio-neuronal linkage.
脑源性神经营养因子（BDNF）是神经营养因子家族的一员，可调节神经元的分化和功能。BDNF水平较低是由心理压力所致，并且可能在抑郁症和认知障碍的发病机制中起作用。由于心理压力和抑郁症与心力衰竭（HF）风险增加相关，HF与心理状态之间的致病联系已引起临床关注。我们推测HF患者的血浆BDNF水平可能降低，并且BDNF可能是与HF相关的关键因素。我们评估了242例HF患者和80例年龄及性别匹配的非HF受试者的血浆BDNF水平。HF患者的血浆BDNF水平（3,712 pg/ml [2,124至6,180]）显著低于非HF患者（7,247 pg/ml [5,388至9,255]，p<0.001），纽约心脏协会功能分级为III级的HF患者低于I级（p = 0.01）和II级患者（p<0.001）。HF患者的对数BDNF水平与对数B型利钠肽呈负相关（r = -0.203，p = 0.03）。在61例急性失代偿性HF患者中，出院时的血浆BDNF水平（4,194 pg/ml [2,356至6,916]）显著高于入院时（2,749 pg/ml [1,380至4,161]，p = 0.003）。多因素逻辑回归分析确定对数BDNF水平与HF的存在显著相关（优势比0.82；95%置信区间0.76至0.91，p<0.001）。总之，HF患者的血浆BDNF水平降低，并与HF严重程度相关。BDNF可能是反映可能的心-神经元联系的潜在临床有用的HF生物标志物。
