Federal State Budgetary Institution, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002, Russian Federation.
Aging (Albany NY). 2021 Jan 11;13(1):194-203. doi: 10.18632/aging.202495.
The aim of the study were to evaluate the prognostic potential of serum level of N-terminal propeptide procollagen type III (PIIINP) and heart parameters for predicting heart cardiac fibrosis 1 year after ST-segment elevation myocardial infarction (STEMI) with preserved left ventricular ejection fraction (LVEF). 68 patients with STEMI and preserved LVEF with acute heart failure of the I-III degree according to the Killip classification were examined. Echocardiography was performed and PIIINP levels were measured on days 1 and 12, as well as 1 year after STEMI. A year after STEMI, was performed contrast magnetic resonance imaging and patients were assigned into four groups depending on the severity of cardiac fibrosis: cardiac fibrosis 0% (n=49, 57% of 86 patients); ≤5% (n=18, 20.9%); 6-15% (n=10, 11.6%); ≥16% (n=9, 10.5%). Direct correlations between the severity of cardiac fibrosis, PIIINP level and indicators of diastolic function were established. The risk of cardiac fibrosis increases at the level of PIIINP ≥381.4 ng / ml on the 12th day after STEMI with preserved LVEF (p=0.048). Thus, measuring the level of PIIINP in the inpatient period can allow timely identification of patients with a high risk of cardiac fibrosis 1 year after STEMI with preserved LVEF.
本研究旨在评估血清Ⅲ型前胶原氨基端肽(PIIINP)水平和心脏参数对预测 ST 段抬高型心肌梗死(STEMI)后 1 年左心室射血分数(LVEF)保留的心力衰竭患者心脏纤维化的预后价值。检查了 68 例 STEMI 合并 LVEF 保留且急性心力衰竭 I-III 级(按 Killip 分级)的患者。进行了超声心动图检查,并在第 1 天、第 12 天以及 STEMI 后 1 年测量 PIIINP 水平。在 STEMI 后 1 年,进行对比磁共振成像,并根据心脏纤维化严重程度将患者分为 4 组:心脏纤维化 0%(n=49,86 例患者中的 57%);≤5%(n=18,20.9%);6-15%(n=10,11.6%);≥16%(n=9,10.5%)。建立了心脏纤维化严重程度、PIIINP 水平与舒张功能指标之间的直接相关性。在保留 LVEF 的 STEMI 后第 12 天,PIIINP 水平≥381.4ng/ml 时,心脏纤维化的风险增加(p=0.048)。因此,在住院期间测量 PIIINP 水平可以及时识别 STEMI 后 1 年 LVEF 保留且心脏纤维化风险较高的患者。