Barman Hasan Ali, Şahin Irfan, Atıcı Adem, Durmaz Eser, Yurtseven Ece, Ikitimur Barış, Okuyan Ertuğrul, Keleş Ibrahim
Department of Cardiology, Okmeydanı Training and Research Hospital; İstanbul-Turkey.
Department of Cardiology, Bağcılar Training and Research Hospital; İstanbul-Turkey.
Anatol J Cardiol. 2019 Nov;22(6):309-316. doi: 10.14744/AnatolJCardiol.2019.37941.
Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family. The aim of the present study was to investigate the relationship between BDNF levels and prognostic markers in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF), considering death or rehospitalization due to HF.
Patients with severe left ventricular systolic dysfunction (LVEF ≤35%) and individuals with no history of cardiac disease (control group) were included in the study conducted between 2013 and 2017. Of the included patients, 52 were classified as mildly symptomatic [New York Heart Association (NYHA) I-II], and 108 were classified as severely symptomatic (NYHA III). The control group comprised 50 individuals. The primary endpoints of the study consisted of cardiovascular death during long-term follow-up and hospitalization for worsening of HF.
The mean age of the patient group was 67.60±11.45 years and 58% were male, whereas that of the control group was 66.28±11.30 years and 48% were male. The N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) serum levels in patients with HF were higher, whereas the BDNF values were lower than those in the control group (NT-pro-BNP: 5010±851 pg/mL vs. 33±11 pg/mL, p<0.001; BDNF: 8.64±1.12 ng/mL vs. 17.58±4.51 ng/mL, p<0.001). Multivariable analysis suggested that there was a significant association between BDNF levels and clinical status, generating the primary endpoints of death [BDNF levels: Odds ratio (OR)=0.17, 95% confidence interval (CI): 0.05-0.53, p=0.002], and rehospitalization (BDNF levels: OR=0.702, 95% CI: 0.54-0.92, p=0.010).
Decreased serum BDNF levels were associated with death and rehospitalization in patients with HF, suggesting that these levels can be useful prognostic biomarkers.
脑源性神经营养因子（BDNF）是神经营养因子家族的一员。本研究旨在探讨心力衰竭（HF）且左心室射血分数（LVEF）降低的患者中BDNF水平与预后标志物之间的关系，同时考虑因HF导致的死亡或再次住院情况。
2013年至2017年期间进行的这项研究纳入了严重左心室收缩功能障碍（LVEF≤35%）的患者以及无心脏病史的个体（对照组）。纳入的患者中，52例被分类为轻度症状[纽约心脏协会（NYHA）I-II级]，108例被分类为重度症状（NYHA III级）。对照组包括50名个体。该研究的主要终点包括长期随访期间的心血管死亡以及因HF恶化而住院。
患者组的平均年龄为67.60±11.45岁，男性占58%，而对照组的平均年龄为66.28±11.30岁，男性占48%。HF患者的N末端脑钠肽前体（NT-pro-BNP）血清水平较高，而BDNF值低于对照组（NT-pro-BNP：5010±851 pg/mL对33±11 pg/mL，p<0.001；BDNF：8.64±1.12 ng/mL对17.58±4.51 ng/mL，p<0.001）。多变量分析表明，BDNF水平与临床状况之间存在显著关联，产生了死亡的主要终点[BDNF水平：比值比（OR）=0.17，95%置信区间（CI）：0.05-0.53，p=0.002]以及再次住院（BDNF水平：OR=0.702，95%CI：0.54-0.92，p=0.010）。
HF患者血清BDNF水平降低与死亡和再次住院相关，表明这些水平可作为有用的预后生物标志物。
