Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, China.
Department of geriatric medicine,Shanxi Dayi Hospital, Taiyuan, Shanxi, China.
Clin Chim Acta. 2019 Aug;495:338-344. doi: 10.1016/j.cca.2019.04.084. Epub 2019 May 3.
Previous study had demonstrated that sestrin2 (Sesn2) expression was increased in human failing heart. Although, the circulating Sesn2 concentrations in patients with chronic heart failure (CHF) remains unknown. This study investigated plasma Sesn2 concentrations in patients with CHF and the role between Sesn2 and the occurrence of major adverse cardiac events.
A total of 80 control subjects and 220 CHF patients were enrolled and the Sesn2 concentrations of each sample were measured. Additionally, the occurrence of major adverse cardiac events in each CHF patient were followed prospectively for 36 months.
Increased plasma Sesn2 concentrations were found in CHF patients and gradually increased from New York Heart Association (NYHA) functional class II to IV. The Sesn2 concentrations were positively correlated with N-terminal B-type natriuretic peptide (NT-pro BNP) but negatively correlated with left ventricular ejection fraction (LVEF) in CHF patients. The ROC curve suggested that Sesn2 had a certain value in predicting major adverse cardiac events during CHF patients, although, the predictive role of Sesn2 is not as good as NT-pro BNP. In addition, the multivariate Cox hazard analysis was performed after the CHF patients were divided into 3 groups (low, middle, and high) base on the plasma Sesn2 concentrations category, and the results showed that both high and middle Sesn2 concentrations increased the incidence of major adverse cardiac events when compared with low Sesn2 group. Furthermore, CHF patients with major adverse cardiac events showed higher Sesn2 concentrations when compared with CHF without major adverse cardiac events. The Kaplan-Meier analysis was performed after the CHF patients were divided into 2 groups according to the median Sesn2 concentrations and the results revealed that patients with high Sesn2 concentrations had a higher risk of major adverse cardiac events compared with those with low Sesn2.
Plasma Sesn2 concentrations were increased in CHF patients and positively correlated with the severity of CHF. Increased Sesn2 concentrations significantly increased the occurrence of major adverse cardiac events and suggested poor outcome in CHF patients.
先前的研究表明,Sestrin2(Sesn2)在人类衰竭心脏中的表达增加。尽管如此,慢性心力衰竭(CHF)患者的循环 Sesn2 浓度仍不清楚。本研究调查了 CHF 患者的血浆 Sesn2 浓度以及 Sesn2 与主要不良心脏事件发生之间的关系。
共纳入 80 名对照受试者和 220 名 CHF 患者,并测量了每个样本的 Sesn2 浓度。此外,前瞻性随访每个 CHF 患者 36 个月的主要不良心脏事件发生情况。
CHF 患者的血浆 Sesn2 浓度升高,且逐渐从纽约心脏协会(NYHA)功能分级 II 增加到 IV。Sesn2 浓度与 CHF 患者的 N 末端 B 型利钠肽(NT-pro BNP)呈正相关,与左心室射血分数(LVEF)呈负相关。ROC 曲线表明,Sesn2 在预测 CHF 患者的主要不良心脏事件方面具有一定价值,尽管其预测作用不如 NT-pro BNP。此外,根据血浆 Sesn2 浓度类别将 CHF 患者分为 3 组(低、中、高)后,进行多变量 Cox 风险分析,结果表明,与低 Sesn2 组相比,高和中 Sesn2 浓度均增加了主要不良心脏事件的发生率。此外,与无主要不良心脏事件的 CHF 患者相比,发生主要不良心脏事件的 CHF 患者的 Sesn2 浓度更高。根据中位数 Sesn2 浓度将 CHF 患者分为 2 组后,进行 Kaplan-Meier 分析,结果表明,Sesn2 浓度较高的患者发生主要不良心脏事件的风险较高。
CHF 患者的血浆 Sesn2 浓度升高,且与 CHF 的严重程度呈正相关。Sesn2 浓度升高显著增加了主要不良心脏事件的发生,并提示 CHF 患者预后不良。