Song Bangrong, Yao Bo, Dang Haiming, Dong Ran
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Cardiology Section 2, Zibo City Linzi District People's Hospital, Zibo 255400, China.
Cardiovasc Diagn Ther. 2020 Apr;10(2):145-152. doi: 10.21037/cdt.2020.01.04.
Hypertrophic cardiomyopathy (HCM) is the most common chromosomal abnormal heart disease. The pathophysiological mechanism of HCM is complex. Several studies have suggested that the level of Soluble ST2 (sST2) may be a biomarker of chronic systolic heart failure, however, the role of sST2 in HCM remains unclear. So we performed this study to analyze the role of Soluble ST2 (sST2), Galectin-3 (Gal-3) and its correlations with clinical prognosis of patients with hypertrophic cardiomyopathy (HCM) undergoing ventricular septal myectomy.
HCM patients who underwent modified Morrow surgery in our hospital during June 2016-June 2018 were included. We divided the patients into different groups stratified by sST2 and Gal-3 level. Besides, we included volunteers without heart disease for medical examination as normal controls. Biochemical analyses were conducted to identify the biomarkers difference. The predictive value of sST2 and Gal-3 on all-cause mortality was evaluated with Cox regression analysis.
A total of 125 HCM patients were included in this present study. The sST2 and Gal-3 levels in HCM patients were significantly higher than that in control group (all P<0.001); there were significant differences in the incidence of all-cause mortality for HCM patients stratified by the sST2 and Gal-3 level; Cox univariate regression survival analysis showed that the hypertension (HR =1.19, 95% CI: 1.01-1.38), maximum wall thickness (HR =1.48, 95% CI: 1.04-1.98), Log sST2 (HR =1.02, 95% CI: 1.01-1.05), Log Gal-3 (HR =1.17, 95% CI: 1.09-1.32) were the predictors for all-cause mortality in patients with HCM, and Cox multivariate risk regression showed that maximum wall thickness was the independent predictors of all-cause mortality in patients with HCM (HR =1.63, 95% CI: 1.35-1.97).
Even through sST2 and Gal-3 were not associated with clinical prognosis of patients with HCM undergoing ventricular septal myectomy, it may be involved in the progress of HCM, more studies are warranted to identify the potential mechanism and reverence value.
肥厚型心肌病（HCM）是最常见的染色体异常心脏病。HCM的病理生理机制复杂。多项研究表明，可溶性ST2（sST2）水平可能是慢性收缩性心力衰竭的生物标志物，然而，sST2在HCM中的作用仍不清楚。因此，我们进行了这项研究，以分析可溶性ST2（sST2）、半乳糖凝集素-3（Gal-3）的作用及其与接受室间隔心肌切除术的肥厚型心肌病（HCM）患者临床预后的相关性。
纳入2016年6月至2018年6月在我院接受改良Morrow手术的HCM患者。我们根据sST2和Gal-3水平将患者分为不同组。此外，我们纳入无心脏病的志愿者进行体检作为正常对照。进行生化分析以确定生物标志物差异。采用Cox回归分析评估sST2和Gal-3对全因死亡率的预测价值。
本研究共纳入125例HCM患者。HCM患者的sST2和Gal-3水平显著高于对照组（均P<0.001）；根据sST2和Gal-3水平分层的HCM患者全因死亡率发生率存在显著差异；Cox单因素回归生存分析显示，高血压（HR =1.19，95%CI：1.01-1.38）、最大壁厚（HR =1.48，95%CI：1.04-1.98）、Log sST2（HR =1.02，95%CI：1.01-1.05）、Log Gal-3（HR =1.17，95%CI：1.09-1.32）是HCM患者全因死亡率的预测因素，Cox多因素风险回归显示最大壁厚是HCM患者全因死亡率的独立预测因素（HR =1.63，95%CI：1.35-1.97）。
尽管sST2和Gal-3与接受室间隔心肌切除术的HCM患者的临床预后无关，但它可能参与了HCM的进展，需要更多的研究来确定其潜在机制和参考价值。
