肺癌患者血清肾上腺髓质素浓度与心肌缺血性T波改变的关系
Relationship Between Serum Concentration of Adrenomedullin and Myocardial Ischemic T Wave Changes in Patients With Lung Cancer.
作者信息
Wu Chen, Lin Da-Wei, Jiang Yi-Wen, Jiang Feng, Wang Zhao-Xia, Wang Yao-Sheng
机构信息
Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Cardiovasc Med. 2022 Mar 7;9:836993. doi: 10.3389/fcvm.2022.836993. eCollection 2022.
BACKGROUND
Patients with lung cancer are at increased risk for the development of cardiovascular diseases. Molecular markers for early diagnosis of cardiac ischemia are of great significance for the early prevention of cardiovascular events in patients with lung cancer. By evaluating the relationship between adrenomedullin (ADM) and myocardial ischemic T wave changes, the clinical value of circulating ADM as a predictor of myocardial ischemia in patients with lung cancer is confirmed.
METHODS
We enrolled patients with lung cancer and healthy people from 2019 to 2021 and extracted a detailed ECG parameter. After adjustment for potential confounders, logistic regression was used to assess the association of clinical data. We performed analyses on differences in T wave between patients with lung cancer and healthy people, and the relationship between T wave and ADM among patients with lung cancer. Receiver operator characteristic (ROC) curves were drawn to confirm the diagnostic value of biomarkers.
RESULTS
After adjusting for potential confounders, the incidence of T wave inversion or flattening in patients with lung cancer was higher than in healthy people (OR: 3.3228, = 0.02). Also, further analysis of the data of lung cancer patients revealed that the ADM in lung cancer patients with T wave inversion or flat was higher than those with normal T wave (189.8 ± 51.9 vs. 131.9 ± 38.4, < 0.001). The area under the ROC curve was 0.8137.
CONCLUSION
Among the patients with lung cancer, serum ADM concentration is associated with the incidence of the abnormal T wave. ADM might be a potentially valuable predictor for heart ischemia in patients with lung cancer.
背景
肺癌患者发生心血管疾病的风险增加。心脏缺血早期诊断的分子标志物对于肺癌患者心血管事件的早期预防具有重要意义。通过评估肾上腺髓质素（ADM）与心肌缺血性T波改变之间的关系，证实了循环ADM作为肺癌患者心肌缺血预测指标的临床价值。
方法
我们纳入了2019年至2021年的肺癌患者和健康人，并提取了详细的心电图参数。在调整潜在混杂因素后，使用逻辑回归评估临床数据的关联。我们对肺癌患者和健康人之间的T波差异以及肺癌患者中T波与ADM之间的关系进行了分析。绘制受试者工作特征（ROC）曲线以确认生物标志物的诊断价值。
结果
在调整潜在混杂因素后，肺癌患者T波倒置或平坦的发生率高于健康人（OR：3.3228，P = 0.02）。此外，对肺癌患者数据的进一步分析显示，T波倒置或平坦的肺癌患者的ADM高于T波正常的患者（189.8±51.9 vs. 131.9±38.4，P < 0.001）。ROC曲线下面积为0.8137。
结论
在肺癌患者中，血清ADM浓度与异常T波的发生率相关。ADM可能是肺癌患者心脏缺血的潜在有价值的预测指标。
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