Suzuki Satoshi, Takeishi Yasuchika
Department of Cardiovascular Medicine, Fukushima Medical University.
Cardiology Department, Takeda General Hospital.
Fukushima J Med Sci. 2018 Dec 8;64(3):116-124. doi: 10.5387/fms.2018-17. Epub 2018 Oct 21.
Heart failure (HF) is a common disease with high prevalence, mortality in hospitalization and after discharge, readmission rates, and burden on healthcare system. Activation of the inflammatory systems is an important role for HF progression, and pentraxin 3 (PTX3) is one of the inflammatory markers. The plasma PTX3 levels increased with advancing the HF severity, and high levels of plasma PTX3 indicated poor prognosis in HF patients. Moreover, we demonstrated that PTX3 had the crucial role for cardiac remodeling under pressure overload using two different genotypes of mice: PTX3 systemic knockout mice and transgenic mice with cardiac-specific overexpression of PTX3.Diuretics are the essential drug for HF treatment, and we designed multicenter, randomized study for evaluating the efficacy and safety of tolvaptan compared to carperitide. Daily urine volume and serum sodium levels were significantly higher, and cardiovascular events were significantly lower in the tolvaptan group than in the carperitide group. Moreover, we investigated the influence of great earthquake in HF patients, and found out that moving into temporary housing by earthquake might affect the incidence of re-hospitalization due to worsening HF.In this review article, we would introduce our research on HF which has various aspects as described above.
心力衰竭(HF)是一种常见疾病,具有高患病率、住院及出院后的死亡率、再入院率以及对医疗系统造成负担。炎症系统的激活在HF进展中起重要作用,而五聚体3(PTX3)是炎症标志物之一。血浆PTX3水平随HF严重程度的增加而升高,血浆PTX3水平高表明HF患者预后不良。此外,我们使用两种不同基因型的小鼠(PTX3全身敲除小鼠和心脏特异性过表达PTX3的转基因小鼠)证明了PTX3在压力过载下心脏重塑中起关键作用。利尿剂是HF治疗的基本药物,我们设计了多中心随机研究来评估托伐普坦与卡培立肽相比的疗效和安全性。托伐普坦组的每日尿量和血清钠水平显著更高,心血管事件显著低于卡培立肽组。此外,我们调查了大地震对HF患者的影响,发现因地震搬入临时住房可能会影响因HF恶化导致的再住院发生率。在这篇综述文章中,我们将介绍我们在HF方面的上述多方面研究。