急性 ST 段抬高型心肌梗死患者血浆神经调节蛋白-1 与心功能的关系。
Relationship between plasma Neuregulin-1 and cardiac function in patients with ST-elevation myocardial infarction.
机构信息
Department of Cardiology, University Heart & Vascular Center Hamburg, 20249 Hamburg, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 22041 Hamburg, Germany.
出版信息
Rev Cardiovasc Med. 2022 Feb 14;23(2):63. doi: 10.31083/j.rcm2302063.
BACKGROUND
Neuregulin-1 (NRG-1) is a stress-mediated transmembrane growth factor. Reduced myocardial damage and higher NRG-1 levels upon treatment with remote ischemic conditioning (RIC) has been described in rats. However, the role of NRG-1 in patients with acute myocardial infarction (MI) is unknown. Thus, we conducted a post hoc analysis of a randomized controlled trial that tested RIC in patients with MI scheduled for primary percutaneous coronary intervention (PCI).
METHODS
Blood was drawn from 30 patients before RIC/PCI, within 1 hour, 4 days and 1 month later. Median left ventricular ejection fraction (LVEF) in the overall study population following MI was 48.5%.
RESULTS
NRG-1 plasma levels decreased significantly following PCI/RIC and remained decreased up to 1 month following MI ( < 0.0001). We observed no association of NRG-1 with other variables, including total ischemic time, LVEF or RIC.
CONCLUSIONS
Thus, we identified NRG-1 may be independently affected by MI. However, further large clinical trials are warranted to clarify this hypothesis.
背景
神经调节蛋白 1（NRG-1）是一种应激介导的跨膜生长因子。在大鼠中，已经描述了远程缺血预处理（RIC）治疗可减少心肌损伤和提高 NRG-1 水平。然而，NRG-1 在急性心肌梗死（MI）患者中的作用尚不清楚。因此，我们对一项随机对照试验进行了事后分析，该试验测试了 MI 患者接受经皮冠状动脉介入治疗（PCI）前的 RIC。
方法
在 RIC/PCI 前、1 小时内、4 天和 1 个月后从 30 例患者中抽取血液。MI 后整个研究人群的中位左心室射血分数（LVEF）为 48.5%。
结果
NRG-1 血浆水平在 PCI/RIC 后显著下降，并在 MI 后 1 个月内持续下降（<0.0001）。我们没有观察到 NRG-1 与其他变量（包括总缺血时间、LVEF 或 RIC）之间存在关联。
结论
因此，我们确定 NRG-1 可能独立于 MI 而受到影响。然而，需要进一步的大型临床试验来阐明这一假设。
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