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急性失代偿性心力衰竭患者中的降钙素抑制肽:来自CATSTAT-HF研究的见解

Catestatin in Acutely Decompensated Heart Failure Patients: Insights from the CATSTAT-HF Study.

作者信息

Borovac Josip A, Glavas Duska, Susilovic Grabovac Zora, Supe Domic Daniela, D'Amario Domenico, Bozic Josko

机构信息

Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia.

Institute of Emergency Medicine of Split-Dalmatia County (ZHM SDZ), Spinciceva 1, 21000 Split, Croatia.

出版信息

J Clin Med. 2019 Jul 30;8(8):1132. doi: 10.3390/jcm8081132.

Abstract

The role of catestatin (CST) in acutely decompensated heart failure (ADHF) and myocardial infarction (MI) is poorly elucidated. Due to the implicated role of CST in the regulation of neurohumoral activity, the goals of the study were to determine CST serum levels among ninety consecutively enrolled ADHF patients, with respect to the MI history and left ventricular ejection fraction (LVEF) and to examine its association with clinical, echocardiographic, and laboratory parameters. CST levels were higher among ADHF patients with MI history, compared to those without (8.94 ± 6.39 vs. 4.90 ± 2.74 ng/mL, = 0.001). CST serum levels did not differ among patients with reduced, midrange, and preserved LVEF (7.74 ± 5.64 vs. 5.75 ± 4.19 vs. 5.35 ± 2.77 ng/mL, = 0.143, respectively). In the multivariable linear regression analysis, CST independently correlated with the NYHA class (β = 0.491, 0.001), waist-to-hip ratio (WHR) (β = -0.237, = 0.026), HbA1c (β = -0.235, = 0.027), LDL (β = -0.231, = 0.029), non-HDL cholesterol (β = -0.237, = 0.026), hs-cTnI (β = -0.221, = 0.030), and the admission and resting heart rate (β = -0.201, = 0.036 and β = -0.242, = 0.030), and was in positive association with most echocardiographic parameters. In conclusion, CST levels were increased in ADHF patients with MI and were overall associated with a favorable cardiometabolic profile but at the same time reflected advanced symptomatic burden (CATSTAT-HF ClinicalTrials.gov number, NCT03389386).

摘要

抑肽素(CST)在急性失代偿性心力衰竭(ADHF)和心肌梗死(MI)中的作用尚不清楚。鉴于CST在神经体液活动调节中的潜在作用,本研究的目的是确定连续纳入的90例ADHF患者的CST血清水平,了解其MI病史和左心室射血分数(LVEF)情况,并研究其与临床、超声心动图和实验室参数的关联。有MI病史的ADHF患者的CST水平高于无MI病史的患者(8.94±6.39 vs. 4.90±2.74 ng/mL,P = 0.001)。LVEF降低、中等范围和保留的患者之间CST血清水平无差异(分别为7.74±5.64 vs. 5.75±4.19 vs. 5.35±2.77 ng/mL,P = 0.143)。在多变量线性回归分析中,CST与纽约心脏协会(NYHA)分级(β = 0.491,P < 0.001)、腰臀比(WHR)(β = -0.237,P = 0.026)、糖化血红蛋白(HbA1c)(β = -0.235,P = 0.027)、低密度脂蛋白(LDL)(β = -0.231,P = 0.029)、非高密度脂蛋白胆固醇(β = -0.237,P = 0.026)、高敏心肌肌钙蛋白I(hs-cTnI)(β = -0.221,P = 0.030)以及入院时和静息心率(β = -0.201,P = 0.036和β = -0.242,P = 0.030)独立相关,并与大多数超声心动图参数呈正相关。总之,有MI的ADHF患者的CST水平升高,总体上与良好的心脏代谢状况相关,但同时也反映了严重的症状负担(CATSTAT-HF临床试验注册号,NCT03389386)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12a1/6722699/c300967590ab/jcm-08-01132-g001.jpg

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