成纤维细胞生长因子 21 与稳定型心绞痛患者 QRS 波群增宽和校正 QT 间期延长有关。
Fibroblast growth factor 21 is associated with widening QRS complex and prolonged corrected QT interval in patients with stable angina.
机构信息
Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445, Taiwan.
School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan.
出版信息
BMC Cardiovasc Disord. 2022 Sep 30;22(1):432. doi: 10.1186/s12872-022-02868-3.
BACKGROUND
Fibroblast growth factor 21 (FGF21) is produced by cardiac cells, may acts in an autocrine manner, and was suggested to has a cardioprotective role in atherosclerosis. Wide QRS complex and heart rate-corrected QT interval (QTc interval) prolongation are associated to dangerous ventricular arrhythmias and cardiovascular disease mortality. Yet, the role of FGF21 in cardiac arrhythmia has never been studied. The aim of the study was to investigate the relationship between plasma FGF21 and the QRS duration and QTc interval in patients with stable angina.
METHODS
Three hundred twenty-one consecutive stable angina patients were investigated. Plasma FGF21 was measured through ELISA, and each subject underwent 12-lead electrocardiography.
RESULTS
FGF21 plasma levels were positively associated with the QRS duration (β = 0.190, P = 0.001) and QTc interval (β = 0.277, P < 0.0001). With increasing FGF21 tertiles, the patients had higher frequencies of wide QRS complex and prolonged QTc interval. After adjusting for patients' anthropometric parameters, the corresponding odd ratios (ORs) for wide QRS complex of the medium and high of FGF21 versus the low of FGF21 were 1.39 (95% CI 0.51-3.90) and 4.41 (95% CI 1.84-11.59), respectively, and p for trend was 0.001. Furthermore, multiple logistic regression analysis also showed the corresponding odd ratios (ORs) for prolonged QTc interval of the medium and high of FGF21 versus the low of FGF21 were 1.02 (95% CI 0.53-1.78) and 1.93 (95% CI 1.04-3.60) respectively with the p for trend of 0.037. In addition, age- and sex-adjusted FGF21 levels were positively associated with fasting glucose, HbA1c, creatinine, and adiponectin, but negatively associated with albumin, and the estimated glomerular filtration rate.
CONCLUSIONS
This study indicates that plasma FGF21 is associated with wide QRS complex and prolonged corrected QT interval in stable angina patients, further study is required to investigate the role of plasma FGF21 for the underlying pathogenesis.
背景
成纤维细胞生长因子 21（FGF21）由心肌细胞产生，可能以自分泌方式发挥作用，并被认为在动脉粥样硬化中有心脏保护作用。宽 QRS 复合物和心率校正的 QT 间期（QTc 间期）延长与危险的室性心律失常和心血管疾病死亡率相关。然而，FGF21 在心脏性心律失常中的作用从未被研究过。本研究的目的是探讨稳定型心绞痛患者血浆 FGF21 与 QRS 持续时间和 QTc 间期的关系。
方法
对 321 例连续稳定型心绞痛患者进行调查。通过 ELISA 测量血浆 FGF21，每位患者均接受 12 导联心电图检查。
结果
FGF21 血浆水平与 QRS 持续时间呈正相关（β=0.190，P=0.001）和 QTc 间期（β=0.277，P<0.0001）。随着 FGF21 三分位的增加，患者出现宽 QRS 复合物和延长 QTc 间期的频率更高。在调整患者的人体测量参数后，中高 FGF21 与低 FGF21 的宽 QRS 复合物的比值比（OR）分别为 1.39（95%CI 0.51-3.90）和 4.41（95%CI 1.84-11.59），趋势 P 值为 0.001。此外，多元逻辑回归分析还显示，中高 FGF21 与低 FGF21 的 QTc 间期延长的比值比（OR）分别为 1.02（95%CI 0.53-1.78）和 1.93（95%CI 1.04-3.60），趋势 P 值为 0.037。此外，年龄和性别调整后的 FGF21 水平与空腹血糖、HbA1c、肌酐和脂联素呈正相关，与白蛋白和估计肾小球滤过率呈负相关。
结论
本研究表明，血浆 FGF21 与稳定型心绞痛患者的宽 QRS 复合物和延长的校正 QT 间期相关，需要进一步研究以探讨血浆 FGF21 在潜在发病机制中的作用。
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