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心肌梗死后左心室射血分数保留 1 年时心脏结构和功能参数及 III 型前胶原 N 端前肽对预测心脏纤维化的预后价值。

Prognostic potential of cardiac structural and functional parameters and N-terminal propeptide of type III procollagen in predicting cardiac fibrosis one year after myocardial infarction with preserved left ventricular ejection fraction.

机构信息

Federal State Budgetary Institution, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002, Russian Federation.

出版信息

Aging (Albany NY). 2021 Jan 11;13(1):194-203. doi: 10.18632/aging.202495.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48ac/7835023/d73e570f8d75/aging-13-202495-g001.jpg

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