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可溶性 ST2 蛋白在男性慢性心力衰竭恶病质患者中的表达。

Soluble ST2 proteins in male cachectic patients with chronic heart failure.

机构信息

Department of Cardiology, 1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland.

Department of Human Physiology, Medical University of Lublin, Lublin, Poland.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):886-893. doi: 10.1016/j.numecd.2020.11.014. Epub 2020 Nov 21.

Abstract

BACKGROUND AND AIMS

Until now, there are lack of established clinical factors allowing management of chronic heart failure (CHF) patients being at risk of cardiac cachexia (CC). The changes in soluble protein ST2 (sST2) concentrations suggest a valuable and prognostic usefulness of this biomarker in monitoring patients with CHF, especially those who potentially are prompt to develop CC. The aim of this study was to assess the potential role of sST2 in male patients with CHF under cachexia condition.

METHODS AND RESULT

91 male patients were selected to the study group and underwent meticulous screening according to recent clinical guidelines in order to CHF and CC detection. Additionally all patients underwent assessment of body composition and sST2 testing. Patients were followed-up for 60 months. Plasma sST2 concentration was significantly increased in cachectic compared with non-cachectic patients (median: 27.40 ng/mL and 20.62 ng/mL; p < 0.001), however, in this group the EF% was reduced (mean: 34 ± 13.5% and 41 ± 14.5%; p = 0.029). Correlations between sST2 and CRP (R = 0.524; p < 0.001) and phase angle (PA) (R = -0.513; p < 0.001) were observed. CHF patients in whose the PA value ranged in Q1 (<3.06°) and sST2 concentration ranged in Q3 (>33.15 ng/mL) had higher risk of death (HR = 9.62 and 8.60, respectively). The death rate was the highest in cachectic group with the simultaneous presence of sST2-Q3 and PA-Q1 (87.5% of this group). They had almost 7-fold higher risk of death during follow-up period (HR = 6.89, p < 0.001).

CONCLUSIONS

sST2 demonstrates potential utility in male patients with CHF under cachexia condition in prediction death rate.

摘要

背景和目的

到目前为止,缺乏既定的临床因素来管理有心脏恶病质(CC)风险的慢性心力衰竭(CHF)患者。可溶性蛋白 ST2(sST2)浓度的变化表明该生物标志物在监测 CHF 患者,特别是那些可能迅速发展为 CC 的患者方面具有有价值和预后作用。本研究旨在评估 sST2 在处于恶病质状态的男性 CHF 患者中的潜在作用。

方法和结果

91 名男性患者被纳入研究组,并根据最近的临床指南进行了细致的筛选,以检测 CHF 和 CC。此外,所有患者均进行了身体成分评估和 sST2 检测。患者随访 60 个月。与非恶病质患者相比,恶病质患者的血浆 sST2 浓度显着升高(中位数:27.40ng/mL 和 20.62ng/mL;p<0.001),但该组的 EF%降低(均值:34±13.5%和 41±14.5%;p=0.029)。观察到 sST2 与 CRP(R=0.524;p<0.001)和相位角(PA)(R=-0.513;p<0.001)之间的相关性。PA 值范围在 Q1(<3.06°)和 sST2 浓度范围在 Q3(>33.15ng/mL)的 CHF 患者死亡风险更高(HR 分别为 9.62 和 8.60)。同时存在 sST2-Q3 和 PA-Q1 的恶病质组的死亡率最高(该组的 87.5%)。他们在随访期间死亡的风险几乎高出 7 倍(HR=6.89,p<0.001)。

结论

sST2 在预测死亡率方面在处于恶病质状态的男性 CHF 患者中具有潜在的应用价值。

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