Yildirim Arafat, Sumbul Hilmi Erdem, Koca Hasan, Kucukosmanoglu Mehmet, Kemal Icen Yahya, Koc Mevlut
Department of Cardiology.
Department of Internal Medicine, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey.
Acta Cardiol Sin. 2021 May;37(3):278-285. doi: 10.6515/ACS.202105_37(3).20201019B.
The relationship between serum complement C1q/tumor necrosis factor (TNF)-related protein-3 (CTRP3) levels and ventricular tachycardia (VT) in heart failure patients with reduced ejection-fraction (HFrEF) is unclear. The aim of this study was to investigate changes in serum CTRP3 level and the relationship with VT in HFrEF.
The study included 88 patients with HFrEF with and without VT and 30 age- and sex-matched healthy controls. Serum CTRP3 levels were measured in addition to routine anamnesis, physical, laboratory and echocardiography examinations. The patients were divided into groups with and without HFrEF and HFrEF patients with and without VT.
Serum CTRP3 levels were significantly lower in the patients with HFrEF than in the control group (206 ± 16 ng/mL and 427 ± 49 ng/mL, p < 0.001). Similarly, CTRP3 levels were lower in the patients with VT (194 ± 10 ng/mL and 216 ± 15 ng/mL, p < 0.001). Left ventricular (LV) volume and tricuspid regurgitation pressure gradient were significantly higher and LV ejection-fraction was significantly lower in the patients with VT (all p < 0.05). Serum CTRP3 and LV end-systolic volume values independently determined the patients with VT (all p < 0.01). Every 10 ng/mL decrease in CTRP3 level increased the odds ratio of VT by 79%. In the receiver operating characteristic curve (ROC) analysis, the area under the ROC curve for CTRP3 was 0.884 (p < 0.001). A CTRP3 cut-off value of 200 ng/mL could predict VT with 88.1% sensitivity and 80.2% specificity.
Serum CTRP3 levels were significantly decreased in the patients with HFrEF, and decreased CTRP3 levels were very closely related to the presence of VT in these patients.
射血分数降低的心力衰竭（HFrEF）患者血清补体C1q/肿瘤坏死因子（TNF）相关蛋白-3（CTRP3）水平与室性心动过速（VT）之间的关系尚不清楚。本研究旨在探讨HFrEF患者血清CTRP3水平的变化及其与VT的关系。
本研究纳入了88例有或无VT的HFrEF患者以及30例年龄和性别匹配的健康对照者。除了进行常规的病史采集、体格检查、实验室检查和超声心动图检查外，还测量了血清CTRP3水平。将患者分为有或无HFrEF组以及有或无VT的HFrEF患者组。
HFrEF患者的血清CTRP3水平显著低于对照组（分别为206±16 ng/mL和427±49 ng/mL，p<0.001）。同样，VT患者的CTRP3水平也较低（分别为194±10 ng/mL和216±15 ng/mL，p<0.001）。VT患者的左心室（LV）容积和三尖瓣反流压力梯度显著更高，而LV射血分数显著更低（均p<0.05）。血清CTRP3和LV收缩末期容积值独立地确定了VT患者（均p<0.01）。CTRP3水平每降低10 ng/mL，VT的比值比增加79%。在受试者工作特征曲线（ROC）分析中，CTRP3的ROC曲线下面积为0.884（p<0.001）。CTRP3临界值为200 ng/mL时，预测VT的敏感性为88.1%，特异性为80.2%。
HFrEF患者的血清CTRP3水平显著降低，CTRP3水平降低与这些患者中VT的存在密切相关。
