Institute for Treatment and Rehabilitation "Niska Banja".
Institute of Pathophysiology, Faculty of Medicine, University of Nis.
Tohoku J Exp Med. 2020 Apr;250(4):233-242. doi: 10.1620/tjem.250.233.
Soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1 represent biomarkers of cardiac remodeling, involved in heart failure (HF) progression. We hypothesize that their plasma concentrations, together with brain natriuretic peptide (BNP), are different in HF stratified by ejection fraction (EF), demonstrating correlations with echocardiographic parameters that indicate left ventricular (LV) hypertrophy; LV mass index (LVMI) and posterior wall and septum diameters. HF patients (n = 77) were classified according to EF: reduced EF < 40% (HFrEF), mid-range EF = 40-49% (HFmrEF), preserved EF > 50% (HFpEF). We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p < 0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p = 0. 002), galectin-3 (p < 0.001), GDF-15 (p = 0.011), and syndecan-1 (p = 0.006), whereas galectin-3 correlated after multivariable adjustments (p = 0.001). Independent correlates of septum and posterior wall diameters, in HFpEF, were sST2 (p = 0.019; p = 0.026), galectin-3 (p = 0.011; p = 0.009), GDF-15 (p = 0.007; p = 0.001), and syndecan-1 (p = 0.005; p = 0.002). In HFrEF, only sST2, adjusted, correlated with LVMI (p = 0.010), whereas BNP correlated with LVMI (p = 0.002) and EF (p = 0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p = 0.046) and HFrEF (p = 0.024). Cardiac remodeling biomarkers are potential circulating indicators of LV hypertrophy in HFpEF, which may ensure timely recognition of disease progression among high-risk patients.
可溶性肿瘤抑制因子 2（sST2）、半乳糖凝集素-3、生长分化因子 15 和 syndecan-1 是心脏重构的生物标志物，参与心力衰竭（HF）的进展。我们假设它们的血浆浓度与脑利钠肽（BNP）一起在按射血分数（EF）分层的 HF 中有所不同，并且与提示左心室（LV）肥厚的超声心动图参数相关，即 LV 质量指数（LVMI）和后壁及室间隔直径。HF 患者（n=77）根据 EF 进行分类：射血分数降低<40%（HFrEF）、射血分数中值=40-49%（HFmrEF）、射血分数保留>50%（HFpEF）。我们发现，四种心脏重构生物标志物的血浆浓度在 HFrEF 中最高，在 HFpEF 中最低，p<0.001。在 HFpEF 中，重塑生物标志物与 LVMI 独立相关：sST2（p=0.002）、半乳糖凝集素-3（p<0.001）、GDF-15（p=0.011）和 syndecan-1（p=0.006），而半乳糖凝集素-3 在多变量调整后相关（p=0.001）。HFpEF 中室间隔和后壁直径的独立相关因素为 sST2（p=0.019；p=0.026）、半乳糖凝集素-3（p=0.011；p=0.009）、GDF-15（p=0.007；p=0.001）和 syndecan-1（p=0.005；p=0.002）。在 HFrEF 中，仅调整后的 sST2 与 LVMI 相关（p=0.010），而 BNP 与 LVMI 相关（p=0.002）和 EF 相关（p=0.001）。GDF-15 与 HFpEF（p=0.046）和 HFrEF（p=0.024）的舒张功能障碍相关。心脏重构生物标志物是 HFpEF 中 LV 肥厚的潜在循环指标，可确保及时识别高危患者的疾病进展。
