Makarović Sandra, Makarović Zorin, Bilić-Ćurčić Ines, Milas-Ahić Jasminka, Mihaljević Ivan, Franceschi Maja, Jukić Tomislav
Clinical Department of Cardiovascular Disease, Osijek University Hospital Centre, School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Clinical Department of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Acta Clin Croat. 2017 Dec;56(4):733-741. doi: 10.20471/acc.2017.56.04.22.
The aim of the study was to assess the role of serum osteoprotegerin (OPG) as a biomarker in patients with aortic valve stenosis (AS) in relation to heart failure and symptomatic status. This was a case control study, which included 51 patients with AS and 39 control subjects. At the time of study enrolment, detailed medical history was obtained and all subjects underwent physical examination, chest x-ray and echocardiography. OPG levels were measured in all subjects, and serum N-terminal of the pro b-type natriuretic peptide (NT pro BNP) levels were determined in patients with AS. Serum OPG levels were elevated in patients with AS compared to control subjects (p=0.001). Patients with heart failure due to AS had elevated serum OPG levels in comparison to patients without heart failure (p=0.001). A significant correlation between OPG and symptomatic status was observed in all patients with AS (p<0.001), however, it was not the case in patients without heart failure (p=0.425). There was a positive correlation between OPG and NT pro BNP concentrations with objective signs of heart failure on chest x-ray (p<0.001). Negative correlation of OPG concentrations with aortic valve area was present (p<0.040), as well as with left ventricular ejection fraction (p<0.001). Serum OPG could be a valuable biomarker in the evaluation of severity of calcified AS and serve as an additional indicator besides clinical presentation and echocardiography in the assessment of surgical treatment or aortic valve replacement.
本研究的目的是评估血清骨保护素（OPG）作为生物标志物在主动脉瓣狭窄（AS）患者中与心力衰竭及症状状态的关系。这是一项病例对照研究，纳入了51例AS患者和39例对照者。在研究入组时，获取了详细的病史，所有受试者均接受了体格检查、胸部X线检查和超声心动图检查。测定了所有受试者的OPG水平，并测定了AS患者的血清氨基末端脑钠肽前体（NT pro BNP）水平。与对照者相比，AS患者的血清OPG水平升高（p = 0.001）。与无心力衰竭的AS患者相比，因AS导致心力衰竭的患者血清OPG水平升高（p = 0.001）。在所有AS患者中观察到OPG与症状状态之间存在显著相关性（p < 0.001），然而，在无心力衰竭的患者中并非如此（p = 0.425）。OPG与NT pro BNP浓度与胸部X线显示的心力衰竭客观体征之间存在正相关（p < 0.001）。OPG浓度与主动脉瓣面积呈负相关（p < 0.040），与左心室射血分数也呈负相关（p < 0.001）。血清OPG可能是评估钙化性AS严重程度的有价值生物标志物，并且除了临床表现和超声心动图外，还可作为评估手术治疗或主动脉瓣置换的额外指标。
