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血清网膜素-1 水平对肥厚型心肌病患者不良心脏事件预测的价值。

Usefulness of Serum Omentin-1 Levels for the Prediction of Adverse Cardiac Events in Patients with Hypertrophic Cardiomyopathy.

机构信息

Department of Cardiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Bagcilar Training and Research Hospital, Istanbul, Turkey.

出版信息

Med Princ Pract. 2018;27(2):107-114. doi: 10.1159/000487396. Epub 2018 Mar 22.

Abstract

OBJECTIVE

To investigate the association between serum omentin-1 levels and adverse cardiac events in patients with hypertrophic cardiomyopathy (HCM).

SUBJECTS AND METHODS

This prospective, observational study included 87 patients with HCM and 50 age- and sex-matched control subjects. Serum omentin-1 and brain natriuretic peptide (BNP) levels were measured in all subjects, using enzyme-linked immunosorbent assay and electrochemiluminescence, respectively. Patients with HCM were divided into 2 groups according to their omentin levels, i.e., low: ≤291 ng/mL (n = 48) and high: > 291 ng/mL (n = 39). Cardiac mortality, hospitalization due to heart failure, and implantable cardioverter-defibrillator (ICD) implantation were considered adverse cardiac events. Statistical analysis included uni- and multivariant logistic regression, receiver-operating characteristic (ROC) analysis, and the Kaplan-Meier method.

RESULTS

Serum omentin-1 levels were significantly lower in the obstructive (253.9 ± 41.3 ng/mL) and nonobstructive (301.9 ± 39.8 ng/mL) HCM groups than in the control group (767.1 ± 56.4 ng/mL), p < 0.001, respectively. The BNP levels were higher in the obstructive and nonobstructive HCM groups than in the control group (269.5 ± 220, 241.0 ± 227, and 24.0 ± 18.9 pg/mL, respectively, p < 0.001). The Kaplan-Meier analysis indicated that patients with low omentin-1 levels showed a significantly higher (48.2%) 2-year cumulative incidence of overall adverse cardiac events than those with high omentin-1 levels (16.2%) (log-rank test, p  =  0.001). In the multivariate logistic regression analysis, omentin-1, interventricular septum (IVS) thickness, and male gender were independent predictors of adverse cardiac events in the follow-up.

CONCLUSION

Omentin-1 levels were lower in patients with HCM than in the control group, and this was associated with worse cardiac outcomes.

摘要

目的

研究血清网膜素-1 水平与肥厚型心肌病(HCM)患者不良心脏事件的关系。

对象和方法

本前瞻性观察研究纳入了 87 例 HCM 患者和 50 名年龄和性别匹配的对照受试者。采用酶联免疫吸附试验和电化学发光法分别检测所有受试者的血清网膜素-1 和脑钠肽(BNP)水平。根据网膜素水平将 HCM 患者分为两组,即低水平组:≤291ng/mL(n=48)和高水平组:>291ng/mL(n=39)。心脏性死亡、心力衰竭住院和植入式心脏复律除颤器(ICD)植入被认为是不良心脏事件。统计分析包括单变量和多变量逻辑回归、受试者工作特征(ROC)分析和 Kaplan-Meier 方法。

结果

梗阻性(253.9±41.3ng/mL)和非梗阻性(301.9±39.8ng/mL)HCM 组患者的血清网膜素-1 水平明显低于对照组(767.1±56.4ng/mL),p<0.001。梗阻性和非梗阻性 HCM 组患者的 BNP 水平高于对照组(分别为 269.5±220、241.0±227 和 24.0±18.9pg/mL),p<0.001。Kaplan-Meier 分析表明,低网膜素-1 水平组患者 2 年总体不良心脏事件累积发生率(48.2%)明显高于高网膜素-1 水平组(16.2%)(对数秩检验,p=0.001)。多变量逻辑回归分析表明,网膜素-1、室间隔(IVS)厚度和男性是随访中不良心脏事件的独立预测因素。

结论

与对照组相比,HCM 患者的血清网膜素-1 水平较低,与较差的心脏预后相关。

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