Özkaramanlı Gür Demet, Sağbaş Miray, Akyüz Aydın, Güzel Savaş, Alpsoy Şeref, Güler Niyazi
Department of Cardiology, Faculty of Medicine, Namık Kemal University; Tekirdağ-Turkey.
Anatol J Cardiol. 2017 Oct;18(4):281-288. doi: 10.14744/AnatolJCardiol.2017.7831. Epub 2017 Aug 11.
Galanin, a cotransmitter similar to neuropeptide Y (NPY), aggravates autonomic imbalance in systolic heart failure (HF) by attenuating vagal tonus after burst sympathetic activity. In animal HF models, galanin antagonists have improved cardiac function. To determine whether galanin is a promising therapeutic target in HF, we studied its concentrations in HF patients and evaluated its correlation with NPY, markers of humoral activity such as pro-BNP and copeptin, and echocardiographic parameters of HF severity.
After recording demographic and echocardiographic characteristics of 87 individuals (57 HF patients and 30 control subjects), fasting serum concentrations of galanin, NPY, copeptin, and pro-BNP were determined.
Unlike pro-BNP, copeptin, and NPY, which were significantly elevated in HF patients (p<0.001, p<0.001, and p=0.001, respectively), galanin was similar in HF patients and control subjects (p=0.9). NPY correlated with the echocardiographic parameters of HF severity (r=-0.22, p=0.03 for EF; r=0.3, p=0.005 for Tei index of RV; r=-0.23, p=0.03 for TAPSE; and r=0.24, p=0.024 for E/e') and pro-BNP (r=0.22, p=0.046). NPY levels were also associated with beta blocker (BB) use, wherein BB significantly decreased NPY in both HF patients and control subjects. Galanin correlated with humoral biomarkers, pro-BNP and copeptin (r=0.39, p<0.001 and r=0.41, p<0.001, respectively). Although current smoking, BB therapy, pro-BNP, copeptin, and body mass index were associated with galanin in univariate analyses, the multiple linear regression model revealed that pro-BNP was the only significant determinant of galanin levels in HF patients.
Our findings confirmed the role of NPY in autonomic balance and suggest that galanin is associated with the proadrenergic state, but its role in HF in humans remains unclear.
甘丙肽是一种与神经肽Y（NPY）类似的共递质，在爆发性交感神经活动后通过减弱迷走神经张力加重收缩性心力衰竭（HF）中的自主神经失衡。在动物HF模型中，甘丙肽拮抗剂可改善心脏功能。为了确定甘丙肽是否是HF中有前景的治疗靶点，我们研究了HF患者中其浓度，并评估了其与NPY、体液活性标志物如脑钠肽前体（pro-BNP）和 copeptin以及HF严重程度的超声心动图参数之间的相关性。
记录87例个体（57例HF患者和30例对照者）的人口统计学和超声心动图特征后，测定空腹血清中甘丙肽、NPY、copeptin和pro-BNP的浓度。
与HF患者中显著升高的pro-BNP、copeptin和NPY不同（分别为p<0.001、p<0.001和p=0.001），HF患者和对照者的甘丙肽水平相似（p=0.9）。NPY与HF严重程度的超声心动图参数相关（射血分数[EF]：r=-0.22，p=0.03；右心室Tei指数：r=0.3，p=0.005；三尖瓣环平面收缩期位移[TAPSE]：r=-0.23，p=0.03；E/A比值：r=0.24，p=0.024）以及与pro-BNP相关（r=0.22，p=0.046）。NPY水平也与β受体阻滞剂（BB）的使用有关，其中BB在HF患者和对照者中均显著降低NPY。甘丙肽与体液生物标志物pro-BNP和copeptin相关（分别为r=0.39，p<0.001和r=0.41，p<0.001）。虽然在单因素分析中当前吸烟、BB治疗、pro-BNP、copeptin和体重指数与甘丙肽有关，但多元线性回归模型显示pro-BNP是HF患者中甘丙肽水平的唯一显著决定因素。
我们的研究结果证实了NPY在自主神经平衡中的作用，并表明甘丙肽与肾上腺素能状态有关，但其在人类HF中的作用仍不清楚。
