Ishiguchi Hironori, Kobayashi Shigeki, Myoren Takeki, Kohno Michiaki, Nanno Takuma, Murakami Wakako, Oda Seiko, Oishi Keishi, Okuda Shinichi, Okada Munemasa, Suga Kazuyoshi, Yano Masafumi
From the Division of Cardiology, Department of Medicine and Clinical Science (H.I., S.K., T.M., M.K., T.N., W.M., S. Oda, K.O., S. Okuda, M.Y.) and Department of Radiology (M.O.), Yamaguchi University Graduate School of Medicine, Ube, Japan; and Department of Radiology, St Hill Hospital, Ube, Japan (K.S.).
Circ Cardiovasc Imaging. 2017 Dec;10(12). doi: 10.1161/CIRCIMAGING.117.006764.
Recently, we reported that urinary 8-hydroxy-2'-deoxyguanosine (U-8-OHdG), an oxidative stress marker, reflected inflammatory activity in cardiac sarcoidosis (CS). Here, we investigated whether U-8-OHdG levels were associated with ventricular tachycardia (VT) in patients with CS.
This prospective cohort study enrolled 62 consecutive patients with CS, of whom 36 were diagnosed as having active CS based on abnormal F-flurodeoxyglucose accumulation in the heart on positron-emission tomography/computed tomography. The 36 patients with active CS were subdivided as having CS with sustained VT (CS-VT group; n=18) or CS without sustained VT (CS-nVT group; n=18). Twenty-seven patients diagnosed with idiopathic dilated cardiomyopathy served as heart failure controls. U-8-OHdG, brain natriuretic peptide, cardiac function indices, and immunohistological data from subendomyocardial biopsy samples were compared across groups. Immunohistochemical examination of ventricle biopsy samples revealed that the anti-8-OHdG antibody-positive area of cardiac tissue was significantly greater in CS-VT than in CS-nVT or dilated cardiomyopathy and significantly correlated with U-8-OHdG levels (n=58; =0.61; <0.00001), which were significantly higher in CS-VT than in CS-nVT (24.6±7.1 versus 15.2±3.8 ng/mg·Cr; <0.0001). Other baseline characteristics did not differ between the groups. Multivariate analysis indicated that U-8-OHdG was an independent determinant factor for VT. Receiver operating characteristic curve analysis to identify patients with VT resulted in a U-8-OHdG cutoff value of 17.5 ng/mg·Cr (sensitivity, 89%; specificity, 83%; area under the curve, 0.90).
U-8-OHdG levels are associated with VT in patients with active CS diagnosed by F-flurodeoxyglucose positron-emission tomography, providing additive and relevant information about the arrhythmia substrate.
最近，我们报道了尿8-羟基-2'-脱氧鸟苷（U-8-OHdG）这一氧化应激标志物可反映心脏结节病（CS）中的炎症活动。在此，我们研究了CS患者中U-8-OHdG水平是否与室性心动过速（VT）相关。
这项前瞻性队列研究连续纳入了62例CS患者，其中36例基于正电子发射断层扫描/计算机断层扫描显示心脏中异常的氟脱氧葡萄糖积聚被诊断为活动性CS。36例活动性CS患者被进一步分为患有持续性VT的CS（CS-VT组；n = 18）或无持续性VT的CS（CS-nVT组；n = 18）。27例被诊断为特发性扩张型心肌病的患者作为心力衰竭对照。对各组的U-8-OHdG、脑钠肽、心功能指标以及心内膜下活检样本的免疫组织学数据进行了比较。心室活检样本的免疫组织化学检查显示，CS-VT组心脏组织的抗8-OHdG抗体阳性面积显著大于CS-nVT组或扩张型心肌病组，且与U-8-OHdG水平显著相关（n = 58；r = 0.61；P < 0.00001），CS-VT组的U-8-OHdG水平显著高于CS-nVT组（24.6±7.1对15.2±3.8 ng/mg·Cr；P < 0.0001）。其他基线特征在各组之间无差异。多因素分析表明，U-8-OHdG是VT的独立决定因素。用于识别VT患者的受试者工作特征曲线分析得出U-8-OHdG的截断值为17.5 ng/mg·Cr（敏感性为89%；特异性为83%；曲线下面积为0.90）。
U-8-OHdG水平与通过氟脱氧葡萄糖正电子发射断层扫描诊断的活动性CS患者的VT相关，为心律失常基质提供了额外的相关信息。
