血清过氧化物酶体增殖物激活受体γ共激活因子-1α与慢性心力衰竭患者心肌能量消耗的关系。
Serum Peroxisome Proliferator-activated Receptor Gamma Coactivator-1α Related to Myocardial Energy Expenditure in Patients With Chronic Heart Failure.
机构信息
State Key Laboratory of Organ Failure Research, Department of Cardiology and; Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, Guangdong, China; Department of Cardiology and.
State Key Laboratory of Organ Failure Research, Department of Cardiology and; Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, Guangdong, China.
出版信息
Am J Med Sci. 2019 Mar;357(3):205-212. doi: 10.1016/j.amjms.2018.12.002. Epub 2018 Dec 7.
BACKGROUND
Peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) plays key roles in controlling cardiac metabolism and function. Myocardial energy expenditure (MEE) can reflect myocardial energy metabolism and cardiac function. Whether the variation of PGC-1α can influence MEE levels in chronic heart failure (CHF) is unclear. Therefore, we investigated the relationship between PGC-1α and MEE.
MATERIAL AND METHODS
We studied 219 patients with CHF and 66 healthy controls. MEE was measured according to echocardiographic parameters. Serum PGC-1α, N-terminal pro-B-type natriuretic peptide and other parameters were detected. Patients with CHF were divided into different groups according to the left ventricular ejection fraction (LVEF) and the tertile range of MEE.
RESULTS
Serum PGC-1α was lower in the MEE 2 and 3 groups compared with controls (both P < 0.05). Patients in the MEE 2 (1.73 ± 0.83 versus 2.16 ± 0.82 ng/mL, P = 0.001) and 3 groups (1.65 ± 0.73 versus 2.16 ± 0.82 ng/mL, P < 0.001) possessed lower levels of PGC-1α than those in the MEE 1 group. Compared with high LVEF, patients with low LVEF had higher MEE (median, 167 versus 73 cal/minute, P < 0.05) and lower PGC-1α (1.71 ± 0.65 versus 1.95 ± 0.91 ng/mL, P = 0.032). Multivariate logistic regression analysis showed that MEE (OR = 0.517, 95% CI = 0.267-0.998, P = 0.049) and creatinine (OR = 2.704, 95% CI = 1.144-6.391, P = 0.023) were independently associated with increased PGC-1α.
CONCLUSIONS
Serum PGC-1α was related to MEE and LVEF in patients with CHF and can reflect the degree of MEE and the systolic function of the left ventricle.
背景
过氧化物酶体增殖物激活受体γ共激活因子-1α（PGC-1α）在控制心脏代谢和功能方面发挥着关键作用。心肌能量消耗（MEE）可以反映心肌能量代谢和心脏功能。PGC-1α 的变化是否会影响慢性心力衰竭（CHF）患者的 MEE 水平尚不清楚。因此，我们研究了 PGC-1α 与 MEE 之间的关系。
材料与方法
我们研究了 219 例 CHF 患者和 66 例健康对照者。根据超声心动图参数测量 MEE。检测血清 PGC-1α、氨基末端脑钠肽前体和其他参数。根据左心室射血分数（LVEF）和 MEE 的三分位范围，将 CHF 患者分为不同组。
结果
与对照组相比，MEE 2 组和 3 组的血清 PGC-1α 水平较低（均 P < 0.05）。MEE 2 组（1.73 ± 0.83 比 2.16 ± 0.82 ng/mL，P = 0.001）和 3 组（1.65 ± 0.73 比 2.16 ± 0.82 ng/mL，P < 0.001）患者的 PGC-1α 水平低于 MEE 1 组。与高 LVEF 相比，低 LVEF 患者的 MEE 更高（中位数 167 比 73 cal/minute，P < 0.05），PGC-1α 水平更低（1.71 ± 0.65 比 1.95 ± 0.91 ng/mL，P = 0.032）。多因素 logistic 回归分析显示，MEE（OR = 0.517，95%CI = 0.267-0.998，P = 0.049）和肌酐（OR = 2.704，95%CI = 1.144-6.391，P = 0.023）与 PGC-1α 升高独立相关。
结论
血清 PGC-1α 与 CHF 患者的 MEE 和 LVEF 相关，可反映 MEE 程度和左心室收缩功能。
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