Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, Japan.
Sci Rep. 2020 Oct 5;10(1):16528. doi: 10.1038/s41598-020-73633-9.
Indoxyl sulfate (IS) is associated with either chronic kidney disease or renal failure, which may predict cardiovascular events via cardiorenal syndrome. The present study aimed to elucidate whether the plasma levels of IS can predict the occurrence of cardiovascular events in patients with chronic heart failure (CHF) and investigate which causes of CHF leading to cardiovascular events are highly influenced by plasma IS levels. We measured the plasma IS levels in 165 patients with CHF [valvular disease: 78, dilated cardiomyopathy: 29, hypertrophic cardiomyopathy (HCM): 25 and others: 33] admitted to our hospital in 2012, and we followed up these patients for more than 5 years (the median follow-up period: 5.3 years). We measured the plasma IS level in 165 patients with CHF, and Kaplan-Meier analyses showed that high plasma IS levels (≥ 0.79 µg/mL, the median value) could predict the occurrence of cardiovascular events, i.e., cardiovascular death or rehospitalization due to the worsening of CHF. The sub-analyses showed that the high IS level could predict cardiovascular events in patients with CHF due to HCM and that the plasma IS levels were closely associated with left ventricular (LV) dimension, LV systolic dysfunction, and plasma B-type natriuretic peptide levels, rather than LV diastolic dysfunction. Plasma IS level predicts cardiovascular events in patients with CHF, especially those with HCM along with cardiac dysfunction. Besides, IS may become a proper biomarker to predict cardiovascular events in patients with CHF.
硫酸吲哚酚（IS）与慢性肾脏病或肾衰竭有关，通过心肾综合征，它可能预测心血管事件。本研究旨在阐明 IS 的血浆水平是否可以预测慢性心力衰竭（CHF）患者发生心血管事件，并探讨导致心血管事件的 CHF 病因中哪些受 IS 血浆水平的影响较大。我们测量了 2012 年我院收治的 165 例 CHF 患者（瓣膜病：78 例，扩张型心肌病：29 例，肥厚型心肌病（HCM）：25 例，其他：33 例）的血浆 IS 水平，对这些患者进行了超过 5 年（中位随访时间：5.3 年）的随访。我们测量了 165 例 CHF 患者的血浆 IS 水平，Kaplan-Meier 分析显示高 IS 水平（≥0.79µg/mL，中位数）可预测心血管事件的发生，即心血管死亡或因 CHF 恶化而再入院。亚组分析显示，高 IS 水平可预测 HCM 引起的 CHF 患者的心血管事件，且 IS 血浆水平与左心室（LV）维度、LV 收缩功能障碍和血浆 B 型利钠肽水平密切相关，而非 LV 舒张功能障碍。IS 血浆水平可预测 CHF 患者的心血管事件，尤其是伴有心功能障碍的 HCM 患者。此外，IS 可能成为预测 CHF 患者心血管事件的合适生物标志物。
