From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.).
Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).
Hypertension. 2019 Apr;73(4):820-828. doi: 10.1161/HYPERTENSIONAHA.118.12261.
The plasma levels of long noncoding RNA LIPCAR are elevated in heart failure (HF) patients with reduced ejection fraction and associated with left ventricular remodeling and poor outcomes. We studied whether the presence of chronic kidney disease (CKD), as defined by an estimated glomerular filtration rate value <60mL/(min·1.73m2) modified the associations of plasma LIPCAR with left ventricular remodeling and outcomes in HF patients. Two hundred and thirty-four patients (mean age 74 [9.14] years, 50% male) were enrolled and followed for 4.73 (0.24-7.25) years. Plasma LIPCAR was detected by real-time quantitative polymerase chain reaction. LIPCAR was increased ( P=0.005) in patients compared with 17 age- and sex-matched controls, directly correlated with age ( P=0.001) and with the maximal early transmitral flow velocity to the mean peak early diastolic velocity of the mitral annulus displacement ratio ( P=0.001) and inversely correlated with estimated glomerular filtration rate ( P<0.001). LIPCAR was associated with hospitalization for HF, cardiovascular death, and a composite of hospitalization for HF or cardiovascular death ( P≤0.010), these associations being dependent of estimated glomerular filtration rate. The interactions between estimated glomerular filtration rate and LIPCAR with respect to these outcomes were statistically significant or of borderline significance ( P≤0.060). LIPCAR was increased in CKD patients compared with non-CKD patients ( P=0.021). LIPCAR was independently associated with hospitalization for HF ( P≤0.039) only in non-CKD patients, but its addition to traditional risk factors did not improve risk prediction in these patients. In conclusion, plasma LIPCAR prognosticates outcomes in elderly HF patients without CKD. Thus, there is an effect modification of CKD on the association of circulating LIPCAR with outcomes in HF patients.
血浆长链非编码 RNA LIPCAR 水平在射血分数降低的心力衰竭 (HF) 患者中升高，并与左心室重构和不良预后相关。我们研究了慢性肾脏病 (CKD) 的存在（定义为估算肾小球滤过率 <60mL/(min·1.73m2)）是否改变了血浆 LIPCAR 与 HF 患者左心室重构和结局的相关性。共纳入 234 例患者（平均年龄 74 [9.14] 岁，50%为男性），随访 4.73（0.24-7.25）年。通过实时定量聚合酶链反应检测血浆 LIPCAR。与 17 名年龄和性别匹配的对照相比，患者的 LIPCAR 增加（P=0.005），与年龄直接相关（P=0.001），与最大早期二尖瓣血流速度与二尖瓣环位移比的平均早期舒张峰值速度（P=0.001）呈负相关，与估算肾小球滤过率呈负相关（P<0.001）。LIPCAR 与 HF 住院、心血管死亡和 HF 住院或心血管死亡的复合终点相关（P≤0.010），这些相关性依赖于估算肾小球滤过率。估算肾小球滤过率和 LIPCAR 与这些结局的相互作用具有统计学意义或边缘意义（P≤0.060）。与非 CKD 患者相比，CKD 患者的 LIPCAR 增加（P=0.021）。仅在非 CKD 患者中，LIPCAR 与 HF 住院相关（P≤0.039），但在这些患者中，将其添加到传统危险因素中并不能改善风险预测。总之，血浆 LIPCAR 预测无 CKD 的老年 HF 患者的结局。因此，CKD 对循环 LIPCAR 与 HF 患者结局的相关性具有效应修饰作用。
