Department of Internal Medicine, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
Department of Internal Medicine, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
Eur J Intern Med. 2019 Jun;64:29-32. doi: 10.1016/j.ejim.2019.04.016. Epub 2019 Apr 26.
Endotrophin, a type VI collagen cleavage product, has fibrosis, and insulin resistance effects. Type VI collagen also plays a role in cardiac fibrosis. In this study, we aimed to investigate the role of endotrophin in the pathogenesis of cardiac fibrosis by determining its levels in patients with heart failure with reduced and mid-range ejection fraction (EF). We also aimed to determine the possible association between endotrophin and treatment that prevents ventricular fibrosis.
Sixty patients with heart failure with reduced and mid-range EF and 27 volunteers with no cardiac failure were included in this study. In both groups, biochemical tests, EF, and endotrophin levels were measured. ELISA was performed for the determination of endotrophin levels.
When compared with the control group, there was no significant difference for endotrophin levels in the patient group (p = .35). Participants in the study were divided into two groups according to their EFs, 40% and less, and 40-49%. They were classified according to their use of renin-angiotensin-aldosterone system (RAAS) blocking drugs. Endotrophin levels were significantly lower in patients with mid-range EFs between 40 and 49% (p = .03) using RAAS blockers.
This study is the first to evaluate the relationship between endotrophin and heart failure. Endotrophin levels were found to be low in patients with heart failure with mid-range EF who were using RAAS blockers. This suggests that RAAS blockers may influence endotrophin levels and thus could have a role in the prevention of remodelling.
内皮质素是一种 VI 型胶原裂解产物，具有纤维化和胰岛素抵抗作用。VI 型胶原也在心脏纤维化中起作用。在这项研究中，我们旨在通过测定心力衰竭伴射血分数降低和中值的患者中的内皮质素水平，来研究内皮质素在心脏纤维化发病机制中的作用。我们还旨在确定内皮质素与预防心室纤维化的治疗之间的可能关联。
本研究纳入了 60 例心力衰竭伴射血分数降低和中值的患者和 27 名无心力衰竭的志愿者。在两组中，均进行了生化检查、EF 和内皮质素水平的测定。采用 ELISA 法测定内皮质素水平。
与对照组相比，患者组的内皮质素水平无显著差异（p=0.35）。根据 EF（40%及以下和 40-49%）将研究参与者分为两组。根据他们使用肾素-血管紧张素-醛固酮系统（RAAS）阻断药物的情况对他们进行分类。使用 RAAS 阻滞剂的 40-49%中等 EF 的患者的内皮质素水平显著降低（p=0.03）。
这是第一项评估内皮质素与心力衰竭之间关系的研究。研究发现，使用 RAAS 阻滞剂的中等 EF 心力衰竭患者的内皮质素水平较低。这表明 RAAS 阻滞剂可能影响内皮质素水平，从而在预防重构中发挥作用。
