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在射血分数降低的人群中,可溶性ST2蛋白与因慢性心力衰竭恶化导致的住院情况在一年随访期间的关系。

Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction.

作者信息

Wojtczak-Soska Karolina, Sakowicz Agata, Pietrucha Tadeusz, Janikowski Kamil, Lelonek Małgorzata

机构信息

Policlinic of Cardiology, Medical University of Lodz, Poland.

Department of Medical Biotechnology, Medical University of Lodz, Poland.

出版信息

Adv Clin Exp Med. 2017 Sep;26(6):931-938. doi: 10.17219/acem/63005.

Abstract

BACKGROUND

Hospitalizations due to worsening chronic heart failure (CHF) are common. However, the relationship between a single measurement of soluble ST2 protein (sST2) and the necessity of hospitalization in CHF is still unclear.

OBJECTIVES

The aim of this study was to determine the association between a single measurement of sST2 concentration and hospitalizations due to worsening CHF during a one-year follow-up.

MATERIAL AND METHODS

The study involved 167 consecutive patients (mean age 63 years, 83% males) with CHF in stable NYHA classes I-III with left ventricular ejection fraction (LVEF) ≤ 45% (median 29.65%, range 13-45%). Fifty-six variables were analyzed (clinical factors, basic laboratory results on admission, standard 12-lead ECG, echocardiography and coronary arteriography results). Information about hospitalizations due to worsening CHF was obtained during telephone interviews conducted 12 months after discharge from the cardiac ward. In order to define factors associated with hospitalization, uniand multivariate regression analyses were performed.

RESULTS

A total of 53 patients from the study group (38%) were hospitalized due to worsening CHF. They included a higher percentage of males (p = 0.042), higher concentrations of sST2 (p = 0.049), and glucose (p = 0.010). The multivariate analysis (for model χ2 = 17.235; p < 0.001) revealed that glucose and sST2 were independently associated with hospitalization due to worsening CHF during the 1-year observation (p < 0.001).

CONCLUSIONS

In patients with stable mild to moderate CHF with reduced EF, a single measurement of sST2 protein and glucose were independent variables for hospitalization due to worsening CHF over a 1-year follow-up period. The defined prognostic model including sST2 and fasting glucose better identified patients without HF-related hospitalizations.

摘要

背景

因慢性心力衰竭(CHF)病情恶化导致的住院情况很常见。然而,可溶性ST2蛋白(sST2)的单次测量值与CHF患者住院必要性之间的关系仍不明确。

目的

本研究旨在确定sST2浓度的单次测量值与1年随访期间因CHF病情恶化导致的住院情况之间的关联。

材料与方法

本研究纳入了167例连续的CHF患者(平均年龄63岁,83%为男性),这些患者NYHA心功能分级为I-III级且病情稳定,左心室射血分数(LVEF)≤45%(中位数29.65%,范围13-45%)。分析了56个变量(临床因素、入院时的基本实验室检查结果、标准12导联心电图、超声心动图和冠状动脉造影结果)。在患者从心脏科病房出院12个月后进行电话访谈,获取因CHF病情恶化导致住院的信息。为了确定与住院相关的因素,进行了单因素和多因素回归分析。

结果

研究组共有53例患者(38%)因CHF病情恶化而住院。这些患者中男性比例更高(p = 0.042),sST2浓度更高(p = 0.049),血糖水平更高(p = 0.010)。多因素分析(模型χ2 = 17.235;p < 0.001)显示,在1年观察期内,血糖和sST2与因CHF病情恶化导致的住院独立相关(p < 0.001)。

结论

在轻度至中度CHF且EF降低的稳定患者中,sST2蛋白和血糖的单次测量值是1年随访期间因CHF病情恶化导致住院的独立变量。包含sST2和空腹血糖的预后模型能更好地识别无HF相关住院的患者。

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