Liu Bo-Han, Li Yan-Guang, Liu Ji-Xuan, Zhao Xiao-Jing, Jia Qia, Liu Chun-Lei, Xu Zhen-Guo, He Kun-Lun
Beijing Key Laboratory of Chronic Heart Failure Precision Medicine, Chinese PLA General Hospital, Beijing, China.
Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
J Geriatr Cardiol. 2019 Apr;16(4):313-319. doi: 10.11909/j.issn.1671-5411.2019.04.002.
Inflammation is an important element of the pathophysiological process of heart failure (HF) and is correlated with subtypes of HF. The association between multiple biomarkers of inflammation and HF subtypes in Chinese subjects remains unclear. This study aimed to compare the differences in inflammation biomarkers among Chinese patients with different subtypes of HF who have been identified to date.
We included 413 consecutive patients with HF, including 262 with preserved ejection fraction (HFpEF), 55 with middle-ranged ejection fraction (HFmrEF) and 96 with reduced ejection fraction (HFrEF). Ten inflammation biomarkers were analyzed and compared according to the HF subtypes. One hundred contemporary non-HF subjects were also recruited as the control group. Moreover, the correlations between the inflammatory biomarkers and left ventricular ejection fraction of the HF subtypes were assessed.
The mean age of the HF patients was 65.0 ± 12.0 years, 65.8% were male. Distinct subtypes of HF demonstrated different inflammation biomarker panels. IL-6, PTX-3, ANGPTL-4 and TNF-α were correlated with HFrEF; IL-1β and PTX-3 were correlated with HFmrEF; and IL-1β and IL-6 were correlated with HFpEF. The multivariable logistic regression showed that IL-1β [relative ratio (RR) = 1.08, 95% CI: 1.02-1.15, = 0.010], IL-6 (RR = 1.03, 95% CI: 1.01-1.06, = 0.016), PTX-3 (RR = 1.31, 95% CI: 1.11-1.55, = 0.001), and ANGPTL-4 (RR = 1.05, 95% CI: 1.02-1.07, < 0.001) were independently associated with HF, while IL-6 (RR = 1.03, 95% CI: 1.01-1.04, = 0.019), PTX-3 (RR = 1.23, 95% CI: 1.06-1.43, = 0.007), and ANGPTL-4 (RR = 1.03, 95% CI: 1.01-1.06, = 0.005) were independently associated with the HF subtype.
Diverse inflammation biomarkers have multifaceted presentations according to the subtype of HF, which may illustrate the diverse mechanisms of inflammation in Chinese HF patients. IL-6, PTX-3, and ANGPTL-4 were independent inflammation factors associated with HFrEF and HF.
炎症是心力衰竭（HF）病理生理过程中的一个重要因素，且与HF的亚型相关。中国人群中多种炎症生物标志物与HF亚型之间的关联尚不清楚。本研究旨在比较迄今已确定的不同亚型中国HF患者炎症生物标志物的差异。
我们纳入了413例连续性HF患者，其中262例射血分数保留（HFpEF），55例射血分数中等范围（HFmrEF），96例射血分数降低（HFrEF）。根据HF亚型分析并比较了10种炎症生物标志物。还招募了100例当代非HF受试者作为对照组。此外，评估了炎症生物标志物与HF亚型左心室射血分数之间的相关性。
HF患者的平均年龄为65.0±12.0岁，男性占65.8%。不同亚型的HF表现出不同的炎症生物标志物谱。白细胞介素-6（IL-6）、3型五聚体蛋白（PTX-3）、血管生成素样蛋白4（ANGPTL-4）和肿瘤坏死因子-α（TNF-α）与HFrEF相关；IL-1β和PTX-3与HFmrEF相关；IL-1β和IL-6与HFpEF相关。多变量逻辑回归显示，IL-1β[相对比率（RR）=1.08，95%置信区间（CI）：1.02 - 1.15，P = 0.010]、IL-6（RR = 1.03，95% CI：1.01 - 1.06，P = 0.016）、PTX-3（RR = 1.31，95% CI：1.11 - 1.55，P = 0.001）和ANGPTL-4（RR = 1.05，95% CI：1.02 - 1.07，P < 0.001）与HF独立相关，而IL-6（RR = 1.03，95% CI：1.01 - 1.04，P = 0.019）、PTX-3（RR = 1.23，95% CI：1.06 - 1.43，P = 0.007）和ANGPTL-4（RR = 1.03，95% CI：1.01 - 1.06，P = 0.005）与HF亚型独立相关。
不同的炎症生物标志物根据HF亚型有多种表现形式，这可能说明了中国HF患者炎症的多种机制。IL-6、PTX-3和ANGPTL-4是与HFrEF和HF相关的独立炎症因子。
