Department of Myocardial Pathology, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111a Kievskaya Str., Tomsk, 634012, Russian Federation.
Department of Pathological Physiology and Clinical Pathophysiology, Novosibirsk State Medical University, Novosibirsk, Russian Federation.
Heart Vessels. 2023 Oct;38(10):1256-1266. doi: 10.1007/s00380-023-02277-2. Epub 2023 Jun 13.
To assess the association of serum tetranectin levels with cardiac remodeling parameters and to evaluate its prognostic role in women with anthracycline-related cardiac dysfunction (ARCD) and without previous cardiovascular diseases (CVD) during 24-month follow-up period. A total of 362 women with primary diagnosed breast cancer who were planned to be treated with anthracyclines were examined. At 12 months after chemotherapy completion, all women were examined and ARCD was diagnosed in 114 patients. After 24 months of follow-up, all patients with ARCD were divided into 2 groups: group 1 comprised women with the adverse course of ARCD (n = 54), group 2 comprised those without it (n = 60). In group 1, the levels of tetranectin were lower than group 2 by 27.6% (p < 0.001) and the patients without ARCD by 33.7% (p < 0.001). In group 1, the levels of tetranectin decreased (p < 0.001) from 11.8 (7.1; 14.3) to 9.02 (5.3; 14.6) pg/mL at 24 months. Moreover, in group 2 (p = 0.871) and in patients without ARCD (p = 0.716), they did not change. The tetranectin values were the independent predictor (odds ratio 7.08; p < 0.001) and its levels ≤ 15/9 ng/mL (AUC = 0.764; p < 0.001) were identified as the predictors for the adverse course of ARCD. NT-proBNP levels did not show the prognostic role, but the addition of NT-proBNP improved prognostic value of analysis (AUC = 0.954; p = 0.002). The cut-off values of tetranectin were established as predictor for adverse course of ARCD, when NT-proBNP was not. The combined use of tetranectin and NT-proBNP demonstrated higher diagnostic value for prediction of adverse outcomes.
评估血清四旋蛋白水平与心脏重构参数的相关性，并在 24 个月的随访期间评估其在无先前心血管疾病（CVD）的蒽环类相关心脏功能障碍（ARCD）女性中的预后作用。共检查了 362 名原发性乳腺癌患者，这些患者计划接受蒽环类药物治疗。化疗完成后 12 个月，所有女性均接受检查，114 名患者被诊断为 ARCD。随访 24 个月后，所有 ARCD 患者分为 2 组：第 1 组包括 ARCD 不良病程的女性（n=54），第 2 组包括无 ARCD 的女性（n=60）。在第 1 组中，四旋蛋白水平比第 2 组低 27.6%（p<0.001），比无 ARCD 的患者低 33.7%（p<0.001）。在第 1 组中，四旋蛋白水平从 11.8（7.1；14.3）pg/mL 降低至 9.02（5.3；14.6）pg/mL（p<0.001）至 24 个月。此外，在第 2 组（p=0.871）和无 ARCD 的患者中（p=0.716），四旋蛋白水平没有变化。四旋蛋白值是独立预测因子（优势比 7.08；p<0.001），其水平≤15/9ng/mL（AUC=0.764；p<0.001）被确定为 ARCD 不良病程的预测因子。NT-proBNP 水平未显示出预后作用，但 NT-proBNP 的加入提高了分析的预后价值（AUC=0.954；p=0.002）。当 NT-proBNP 不可用时，建立四旋蛋白水平的截断值作为 ARCD 不良病程的预测因子。四旋蛋白和 NT-proBNP 的联合使用显示出更高的预测不良结局的诊断价值。
