有无冠状动脉疾病患者心包液中生长分化因子15水平：一项前瞻性研究。
Pericardial fluid levels of growth differentiation factor 15 in patients with or without coronary artery disease: a prospective study.
作者信息
Yuan Zhize, Li Haiqing, Sun Yanjun, Qiu Jiapei, Xu Hong, Liu Jun, Zhou Mi, Chen Anqing, Ye Xiaofeng, Wang Zhe, Zhao Qiang
机构信息
Department of Cardiac Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
出版信息
Ann Transl Med. 2020 Feb;8(4):113. doi: 10.21037/jtd.2019.12.92.
BACKGROUND
Growth differentiation factor 15 (GDF15) has already been reported as a novel efficient biomarker in patients with coronary artery diseases (CAD). However, very little is demonstrated about the potential impact of pericardial fluid GDF-15 accumulation on CAD. The aim of this study was to evaluate pericardial fluid and plasma GDF15 levels in patients with ischemic heart disease.
METHODS
In this study, 42 consecutive patients (21 patients with significant CAD; 21 patients without CAD) undergoing open heart surgery were recruited in this study. Pericardial fluid were obtained at the time of surgery, and GDF15 levels in the samples were measured by enzyme-linked immunosorbent assay. Plasma glucose, creatinine, CK-MB, cTnI and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements were performed.
RESULTS
The plasma GDF15 levels were markedly higher than the pericardial fluid levels both in the CAD group and non-CAD group (1,174.0±148.7 . 677.8±77.2 pg/mL, P<0.01; 925.8±127.4 . 617.4±76.2 pg/mL, P<0.01). The levels of pericardial fluid GDF15, was not statistically different between the CAD and non-CAD groups (P>0.05). An obvious correlation was observed between plasma and pericardial fluid GDF15 concentration both in the CAD group and non-CAD group (R=0.53, P<0.01; R=0.54, P<0.01). An obvious positive correlation was found between pericardial fluid GDF15 and plasma creatinine levels in CAD patients but not in non-CAD patients (R=0.65, P<0.01). In the CAD group, an obvious correlation was also observed between pericardial fluid GDF15 levels and NT-ProBNP (R=0.63, P<0.01), while no relationship was found in non-CAD group. There was a positive correlation between pericardial fluid GDF15 and LVEF in non-CAD group but not in CAD group patients (R=-0.44, P<0.05).
CONCLUSIONS
Our study first revealed an association between pericardial fluid GDF15 and baseline characteristics. Pericardial fluid GDF15 levels are associated with cardiac and kidney function in patients with coronary artery disease and may be a valuable marker for assessing CAD severity and predicting its complications.
背景
生长分化因子15（GDF15）已被报道为冠状动脉疾病（CAD）患者一种新型有效的生物标志物。然而，关于心包积液中GDF-15积聚对CAD的潜在影响，目前所知甚少。本研究旨在评估缺血性心脏病患者心包积液和血浆中的GDF15水平。
方法
本研究纳入了42例连续接受心脏直视手术的患者（21例患有严重CAD；21例无CAD）。手术时获取心包积液，通过酶联免疫吸附测定法测量样本中的GDF15水平。同时进行血浆葡萄糖、肌酐、肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）和N末端B型利钠肽原（NT-proBNP）的检测。
结果
CAD组和非CAD组血浆GDF15水平均显著高于心包积液水平（1,174.0±148.7. 677.8±77.2 pg/mL，P<0.01；925.8±127.4. 617.4±76.2 pg/mL，P<0.01）。CAD组和非CAD组心包积液GDF15水平无统计学差异（P>0.05）。CAD组和非CAD组血浆和心包积液GDF15浓度之间均存在明显相关性（R=0.53，P<0.01；R=0.54，P<0.01）。CAD患者心包积液GDF15与血浆肌酐水平之间存在明显正相关，而非CAD患者则无此相关性（R=0.65，P<0.01）。在CAD组中，心包积液GDF15水平与NT-ProBNP之间也存在明显相关性（R=0.63，P<0.01），而非CAD组未发现相关性。非CAD组心包积液GDF15与左心室射血分数（LVEF）呈正相关，而CAD组患者则无此相关性（R=-0.44，P<0.05）。
结论
我们的研究首次揭示了心包积液GDF15与基线特征之间的关联。心包积液GDF15水平与冠状动脉疾病患者的心脏和肾脏功能相关，可能是评估CAD严重程度和预测其并发症的有价值标志物。
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