Oregon Health & Science University, School of Nursing, Portland, OR, USA.
Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA.
Eur J Cardiovasc Nurs. 2023 Mar 1;22(2):149-157. doi: 10.1093/eurjcn/zvac054.
Physical frailty is highly prevalent and predictive of worse outcomes in heart failure (HF). Candidate biomarker analysis may help in understanding the mechanisms underlying physical frailty in HF. We aimed to identify candidate biomarkers associated with physical frailty in HF using a multimarker strategy of distinct pathophysiological processes.
We collected data and plasma samples from 113 adults with New York Heart Association Functional Class I-IV HF. Physical frailty was measured with the Frailty Phenotype Criteria. Plasma biomarkers included: N-terminal pro-B-type natriuretic peptide, norepinephrine, dihydroxyphenylglycol, soluble tumour necrosis factor alpha receptor-1, adiponectin, insulin, glucose, insulin-like growth factor-1 (IGF-1), and myostatin. Comparative statistics and multivariate linear regression were used to test group differences and associations. The average age was 63.5 ± 15.7 years, half were women (48%), and most had a non-ischaemic aetiology of HF (73%). Physical frailty was identified in 42% and associated with female sex, higher body mass index and percent body fat, more comorbidities, and HF with preserved ejection fraction. Adjusting for Seattle HF Model projected survival score, comorbidities, body composition, and sex, physical frailty was associated with significantly lower plasma adiponectin [β ± standard error (SE) -0.28 ± 0.14, P = 0.047], IGF-1 (β ± SE -0.21 ± 0.10, P = 0.032), and myostatin (β ± SE -0.22 ± 0.09, P = 0.011). In sex-stratified analyses, IGF-1 and myostatin were significantly associated with physical frailty in men but not women.
We identified biomarkers involved in adipose tissue and skeletal muscle development, maintenance, and function that were associated with physical frailty in HF.
身体虚弱在心力衰竭（HF）中非常普遍，并且可以预测更差的结局。候选生物标志物分析可能有助于了解 HF 中身体虚弱的潜在机制。我们旨在使用不同病理生理过程的多标志物策略，确定与 HF 中身体虚弱相关的候选生物标志物。
我们从 113 名纽约心脏协会功能 I-IV 级 HF 的成年人中收集数据和血浆样本。使用虚弱表型标准测量身体虚弱。血浆生物标志物包括：N 末端 pro-B 型利钠肽、去甲肾上腺素、二羟苯乙二醇、可溶性肿瘤坏死因子受体-1、脂联素、胰岛素、葡萄糖、胰岛素样生长因子-1（IGF-1）和肌肉生长抑制素。比较统计和多元线性回归用于检验组间差异和相关性。平均年龄为 63.5±15.7 岁，一半为女性（48%），大多数为非缺血性 HF（73%）。42%的患者存在身体虚弱，与女性、较高的体重指数和体脂百分比、更多的合并症以及射血分数保留的 HF 相关。调整西雅图 HF 模型预测的生存评分、合并症、身体成分和性别后，身体虚弱与血浆脂联素显著降低相关[β±标准误（SE）-0.28±0.14，P=0.047]、IGF-1[β±SE-0.21±0.10，P=0.032]和肌肉生长抑制素[β±SE-0.22±0.09，P=0.011]。在性别分层分析中，IGF-1 和肌肉生长抑制素与男性的身体虚弱显著相关，但与女性无关。
我们确定了与 HF 中身体虚弱相关的参与脂肪组织和骨骼肌发育、维持和功能的生物标志物。
