Tanaka Chiharu, Kurose Satoshi, Morinaga Jun, Takao Nana, Miyauchi Takumi, Tsutsumi Hiromi, Shiojima Ichiro, Oike Yuichi, Kimura Yutaka
Department of Health Science, Kansai Medical University.
Division of Cardiology, Department of Medicine II, Kansai Medical University.
Int Heart J. 2021 Sep 30;62(5):980-987. doi: 10.1536/ihj.21-106. Epub 2021 Sep 17.
Angiopoietin-like protein 2 (ANGPTL2) promotes chronic inflammation and plays a key role in the pathogenesis of heart failure. Cardiac rehabilitation (CR) is an integral component of heart failure management and has been shown to have anti-inflammatory effects. However, ANGPTL2 concentration in chronic heart failure patients undergoing CR has not been evaluated. This study aimed to investigate serum ANGPTL2 levels and their associated factors and compare the results with those of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic heart failure undergoing phase III CR.A total of 56 patients were enrolled. Clinical characteristics including body composition, grip strength, exercise tolerance, duration of CR, blood counts and biochemistry, and echocardiographic parameters were evaluated for their association with serum ANGPTL2 and NT-proBNP levels.The median (first and third quartiles) value of ANGPTL2 was 4.05 (2.70-5.57) ng/mL. Clinical parameters that correlated with serum ANGPTL2 levels were body weight, body mass index, body fat mass, body fat percentage, anaerobic threshold (AT), C-reactive protein, and total protein (TP), which were mostly distinct from those that correlated with serum NT-proBNP levels. A multivariate analysis revealed that AT and TP were independent factors related to ANGPTL2 levels, whereas age, left ventricular ejection fraction, and left atrial dimension were independently related to NT-proBNP levels.These observations suggest that CR increases the exercise tolerance and exhibits anti-inflammatory effects simultaneously, and this situation is reflected by decreased serum ANGPLT2 and TP levels. ANGPTL2 may be a useful marker of inflammation and impaired exercise tolerance in patients with chronic heart failure.
血管生成素样蛋白2（ANGPTL2）促进慢性炎症，在心力衰竭的发病机制中起关键作用。心脏康复（CR）是心力衰竭管理的一个重要组成部分，已被证明具有抗炎作用。然而，尚未评估接受CR的慢性心力衰竭患者的ANGPTL2浓度。本研究旨在调查慢性心力衰竭患者在接受III期CR时的血清ANGPTL2水平及其相关因素，并将结果与N端前脑钠肽（NT-proBNP）的结果进行比较。总共招募了56名患者。评估了包括身体成分、握力、运动耐量、CR持续时间、血细胞计数和生化指标以及超声心动图参数在内的临床特征与血清ANGPTL2和NT-proBNP水平的相关性。ANGPTL2的中位数（第一和第三四分位数）值为4.05（2.70-5.57）ng/mL。与血清ANGPTL2水平相关的临床参数包括体重、体重指数、体脂肪量、体脂肪百分比、无氧阈值（AT）、C反应蛋白和总蛋白（TP），这些参数大多与与血清NT-proBNP水平相关的参数不同。多变量分析显示，AT和TP是与ANGPTL2水平相关的独立因素，而年龄、左心室射血分数和左心房内径与NT-proBNP水平独立相关。这些观察结果表明，CR可提高运动耐量并同时发挥抗炎作用，血清ANGPLT2和TP水平降低反映了这种情况。ANGPTL2可能是慢性心力衰竭患者炎症和运动耐量受损的有用标志物。
