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应用炎症生物标志物和实时心导管术评估舒张性心力衰竭患者的左心室舒张功能。

Use of Inflammatory Biomarkers and Real-Time Cardiac Catheterisation to Evaluate the Left Ventricular Diastolic Function in Patients With Diastolic Heart Failure.

机构信息

Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China.

School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, China.

出版信息

Heart Lung Circ. 2021 Mar;30(3):396-403. doi: 10.1016/j.hlc.2020.06.017. Epub 2020 Jul 20.

Abstract

BACKGROUND

Interleukin (IL)-17 and its related cytokines have been shown to be involved in myocardial fibrosis and irreversible ventricular remodelling, which have predictive values in the development of left ventricular diastolic dysfunction (LVDD). This study aimed to assess the correlation between IL-17 and LVDD, and investigate the prognostic value of IL-17 among patients with normal left ventricular ejection fraction (LVEF).

METHODS

A total of 120 patients with normal LVEF underwent left ventricular (LV) catheterisation for LV end-diastolic pressure (LVEDP) measurement and routine echocardiography. The follow-up period was 30 (18, 35) months.

RESULTS

The levels of IL-17 and IL-6 from the systemic blood were significantly increased in non-heart failure (HF) patients with LVDD (p<0.001). Receiver operating characteristic (ROC) revealed that the combination of IL-17 and IL-6 showed the highest diagnostic accuracy in predicting LVDD (AUC, 0.890; 95% CI, 0.835-0.945; p<0.001), and the cut-off value was 41.5 pg/mL. On logistic regression analysis, the increment of the combination of IL-17 and IL-6 was an independent predictor for the prognosis of LVDD (odds ratio, 1.25; 95% CI, 1.01-1.12; p<0.05). According to the cut-off value of the combination of IL-17 and IL-6, the patients with lower levels of IL-17 and IL-6 (<41.5 pg/mL group) had a better prognosis. The increased levels of IL17 and IL-6 were significantly correlated with the levels of fibrotic parameters.

CONCLUSIONS

Assessment of LVDD by measuring the combination of IL-17 and IL-6 might provide valuable prognostic significance for non-HF patients with LVDD.

摘要

背景

白细胞介素(IL)-17 及其相关细胞因子已被证明参与心肌纤维化和心室重构,这在左心室舒张功能障碍(LVDD)的发展中具有预测价值。本研究旨在评估 IL-17 与 LVDD 的相关性,并研究 IL-17 在左心室射血分数(LVEF)正常的患者中的预后价值。

方法

共 120 例 LVEF 正常的患者接受左心室(LV)导管检查以测量 LV 舒张末期压(LVEDP)和常规超声心动图检查。随访时间为 30(18,35)个月。

结果

LVDD 非心力衰竭(HF)患者的系统性血液中 IL-17 和 IL-6 水平显著升高(p<0.001)。受试者工作特征(ROC)曲线显示,IL-17 和 IL-6 的联合检测对 LVDD 的预测具有最高的诊断准确性(AUC,0.890;95%CI,0.835-0.945;p<0.001),其截断值为 41.5pg/ml。在 logistic 回归分析中,IL-17 和 IL-6 联合升高是 LVDD 预后的独立预测因素(比值比,1.25;95%CI,1.01-1.12;p<0.05)。根据 IL-17 和 IL-6 联合检测的截断值,IL-17 和 IL-6 水平较低(<41.5pg/ml 组)的患者预后较好。IL17 和 IL-6 水平的升高与纤维化参数水平显著相关。

结论

通过测量 IL-17 和 IL-6 的联合检测来评估 LVDD 可能为 LVDD 的非 HF 患者提供有价值的预后意义。

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