Thorsen Inga Strand, Gøransson Lasse G, Ueland Thor, Aukrust Pål, Manhenke Cord A, Skadberg Øyvind, Jonsson Grete, Ørn Stein
Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Int J Cardiol Heart Vasc. 2021 Feb 19;33:100727. doi: 10.1016/j.ijcha.2021.100727. eCollection 2021 Apr.
Fibroblast growth factor 23 (FGF23) is a regulator of mineral metabolism, that has been linked to myocardial remodeling including development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aim of this study was to investigate the relationship between intact FGF23 (iFGF23), myocardial infarct size and LV remodeling following a first acute ST-elevation myocardial infarction (STEMI).
Forty-two consecutive patients with first-time STEMI, single vessel disease, successfully treated with primary percutaneous coronary intervention were included. Cardiac magnetic resonance (CMR) imaging was performed at day 2, 1 week, 2 months and 1 year post MI, and blood samples were drawn at admittance and at the same time points as the CMRs. The cohort was divided according to the presence or not of heart failure post MI. In the total cohort, iFGF23 (mean ± SD) was significantly lower at day 0 (33.7 ± 20.6 pg/ml) and day 2 (31.5 ± 23.4 pg/ml) compared with a reference interval based on 8 healthy adults (43.9 pg/ml ± 19.0 pg/ml). iFGF23 increased to normal levels (55.8 ± 23.4 pg/ml) seven days post MI. In the subset of patients with signs of acute heart failure, FGF23 was higher at all measured timepoints, reaching significantly higher FGF23 levels at 2 months and 1 year following revascularization.
There was a reduction in iFGF23 levels during the acute phase of MI, with a normalization at seven days following revascularization. During one-year follow-up, there was a gradual increase in iFGF23 levels in patients with heart failure.
成纤维细胞生长因子23（FGF23）是矿物质代谢的调节剂，与心肌重塑有关，包括左心室（LV）肥厚和心肌纤维化的发展。本研究的目的是探讨首次急性ST段抬高型心肌梗死（STEMI）后完整FGF23（iFGF23）、心肌梗死面积与左心室重塑之间的关系。
纳入42例首次发生STEMI、单支血管病变且成功接受直接经皮冠状动脉介入治疗的连续患者。在心肌梗死后第2天、1周、2个月和1年进行心脏磁共振（CMR）成像，并在入院时以及与CMR相同的时间点采集血样。根据心肌梗死后是否存在心力衰竭对该队列进行分组。在整个队列中，与基于8名健康成年人的参考区间（43.9 pg/ml±19.0 pg/ml）相比，iFGF23（平均值±标准差）在第0天（33.7±20.6 pg/ml）和第2天（31.5±23.4 pg/ml）显著降低。心肌梗死后7天，iFGF23升高至正常水平（55.8±23.4 pg/ml）。在有急性心力衰竭体征的患者亚组中，FGF23在所有测量时间点均较高，在血运重建后2个月和1年时FGF23水平显著更高。
心肌梗死急性期iFGF23水平降低，血运重建后7天恢复正常。在一年的随访期间，心力衰竭患者的iFGF23水平逐渐升高。
