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经导管主动脉瓣植入术(TAVI)后患者的多生物标志物分析。

Multi-biomarker analysis in patients after transcatheter aortic valve implantation (TAVI).

作者信息

Mirna Moritz, Wernly Bernhard, Paar Vera, Jung Christian, Jirak Peter, Figulla Hans-Reiner, Kretzschmar Daniel, Franz Marcus, Hoppe Uta C, Lichtenauer Michael, Lauten Alexander

机构信息

a Clinic of Internal Medicine II, Department of Cardiology , Paracelsus Medical University of Salzburg , Salzburg , Austria.

b Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty , University Duesseldorf , Duesseldorf , Germany.

出版信息

Biomarkers. 2018 Dec;23(8):773-780. doi: 10.1080/1354750X.2018.1499127. Epub 2018 Aug 31.

Abstract

BACKGROUND

In this study we sought to examine whether transcatheter aortic valve implantation (TAVI) is followed by a change in the plasma levels of novel cardiovascular biomarkers.

METHODS

We collected blood samples of 79 patients with severe aortic valve stenosis undergoing TAVI before and at 7 days, 1 month, 3 months and 6 months post TAVI and analyzed the plasma concentrations of GDF-15, H-FABP, fetuin-A, galectin 3, sST2 and suPAR by means of ELISA.

RESULTS

There was a significant increase in the concentration of fetuin-A (median: 52.44 mg/ml to 113.2 mg/ml, p < 0.001) and a significant decrease of H-FABP after TAVI (median: 4.835 ng/ml to 2.534 ng/ml, p < 0.001). The concentrations of suPAR and sST2 showed an initial increase (suPAR median: 2755 pg/ml 3489 pg/ml, p < 0.001; sST2 median: 5832 pg/ml to 7137 pq/ml, p < 0.001) and subsequently decreased significantly.

CONCLUSION

We hypothesize that the decrease of H-FABP and the increase of fetuin-A could be due to a hemodynamic improvement after valve replacement. The initial increase of suPAR could indicate an inflammatory stimulus and the significant increase in sST2 could be due to the mechanical strain caused by implantation of the valve.

摘要

背景

在本研究中,我们试图探究经导管主动脉瓣植入术(TAVI)后新型心血管生物标志物的血浆水平是否发生变化。

方法

我们收集了79例重度主动脉瓣狭窄患者在TAVI术前以及术后7天、1个月、3个月和6个月的血样,并通过酶联免疫吸附测定法(ELISA)分析了血浆中生长分化因子15(GDF-15)、心脏型脂肪酸结合蛋白(H-FABP)、胎球蛋白-A、半乳糖凝集素3、可溶性生长刺激表达基因2蛋白(sST2)和可溶性尿激酶型纤溶酶原激活物受体(suPAR)的浓度。

结果

TAVI术后,胎球蛋白-A浓度显著升高(中位数:从52.44毫克/毫升升至113.2毫克/毫升,p<0.001),H-FABP显著降低(中位数:从4.835纳克/毫升降至2.534纳克/毫升,p<0.001)。suPAR和sST2的浓度起初升高(suPAR中位数:从2755皮克/毫升升至3489皮克/毫升,p<0.001;sST2中位数:从5832皮克/毫升升至7137皮克/毫升,p<0.001),随后显著下降。

结论

我们推测,H-FABP的降低和胎球蛋白-A的升高可能是由于瓣膜置换术后血流动力学改善所致。suPAR起初升高可能表明存在炎症刺激,而sST2的显著升高可能是由于瓣膜植入引起的机械应变所致。

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