Podzimkova J, Palecek T, Kuchynka P, Marek J, Danek B A, Jachymova M, Kalousova M, Zima T, Linhart A
2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague, Czech Republic.
Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Herz. 2019 Jun;44(4):347-353. doi: 10.1007/s00059-017-4645-3. Epub 2017 Nov 16.
Osteopontin (OPN) is an extracellular matrix glycoprotein that plays a role in a variety of cellular activities associated with inflammatory and fibrotic responses. Increased OPN levels in myocardium and plasma have been demonstrated in patients with dilated cardiomyopathy (DCM). However, nothing is known about OPN levels in patients with hypertrophic cardiomyopathy (HCM). Therefore, the aim of our study was to compare plasma OPN levels in patients with these two most common cardiomyopathies.
We examined plasma OPN as well as creatinine, C‑reactive protein (CRP), brain-type natriuretic peptide (BNP), and troponin I levels in 64 patients with DCM, 43 patients with HCM, and 75 control subjects. Transthoracic echocardiography was also performed on all cardiomyopathy patients.
Plasma OPN levels were significantly elevated in patients with DCM compared with HCM patients (95 ± 43 vs. 57 ± 21 ng/ml; p < 0.001) and control subjects (54 ± 19 ng/ml; p < 0.001); however, there was no difference between HCM patients and control subjects. New York Heart Association (NYHA) class III or IV disease was more frequently present in DCM patients than in HCM subjects (44 % vs. 2 %, p < 0.0001). In multivariate analysis, BNP and CRP levels together with NYHA class were found to be significant predictors of plasma OPN levels in DCM patients (p = 0.002, p = 0.029, and p < 0.001 for BNP, CRP, and NYHA, respectively).
Plasma OPN levels were associated with overall heart failure severity rather than with specific cardiomyopathy subtype in patients suffering from DCM or HCM, respectively.
骨桥蛋白(OPN)是一种细胞外基质糖蛋白,在与炎症和纤维化反应相关的多种细胞活动中发挥作用。扩张型心肌病(DCM)患者心肌和血浆中的OPN水平已被证实升高。然而,肥厚型心肌病(HCM)患者的OPN水平尚不清楚。因此,我们研究的目的是比较这两种最常见心肌病患者的血浆OPN水平。
我们检测了64例DCM患者、43例HCM患者和75例对照者的血浆OPN以及肌酐、C反应蛋白(CRP)、脑钠肽(BNP)和肌钙蛋白I水平。所有心肌病患者均进行了经胸超声心动图检查。
与HCM患者(95±43 vs. 57±21 ng/ml;p<0.001)和对照者(54±19 ng/ml;p<0.001)相比,DCM患者的血浆OPN水平显著升高;然而,HCM患者与对照者之间没有差异。纽约心脏协会(NYHA)III级或IV级疾病在DCM患者中比在HCM患者中更常见(44% vs. 2%,p<0.0001)。在多变量分析中,发现BNP和CRP水平以及NYHA分级是DCM患者血浆OPN水平的显著预测因素(BNP、CRP和NYHA的p值分别为0.002、0.029和p<0.001)。
在分别患有DCM或HCM的患者中,血浆OPN水平与总体心力衰竭严重程度相关,而非与特定的心肌病亚型相关。