Li Huan, Ren Yahui, Wang Linfang, Li Yuming
Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Front Endocrinol (Lausanne). 2024 Feb 5;15:1333001. doi: 10.3389/fendo.2024.1333001. eCollection 2024.
Left ventricular (LV) diastolic dysfunction is an independent predictor of future cardiovascular events. Early detection of patients with LV diastolic dysfunction can improve clinical outcomes through active management. However, the assessment of diastolic function is very complicated, and there are currently lack of effective biomarkers to assess the risk of LV diastolic dysfunction. Connective tissue growth factor (CTGF) plays a significant role in cardiac remodeling and dysfunction. We aimed to investigate the associations between plasma CTGF level and the risk of LV diastolic dysfunction in this study and judge its effectiveness in diagnosing LV diastolic dysfunction.
A total of 169 patients with overt hyperthyroidism were included. LV diastolic function was evaluated and the subjects were divided into normal LV diastolic function group and LV diastolic dysfunction group. Routine clinical medical data, biochemical data, thyroid related parameters and echocardiographic parameters were recorded for analysis.
Compared with normal LV diastolic function group, the LV diastolic dysfunction group had higher age and BMI, as well as lower heart rate, lower serum albumin, lower eGFR, higher serum TgAb and BNP level, and the incidences of hypertension were also higher (all <0.05). Circulating plasma CTGF levels in the LV diastolic dysfunction group were significantly higher (normal LV diastolic function group: 7.026 [5.567-8.895], LV diastolic dysfunction group: 8.290 [7.054-9.225] ng/ml, median [(Interquartile range)], = 0.004); Compared with the lowest quartile group, the crude odds ratios (OR) of LV diastolic dysfunction in the second, third, and fourth quartile group were 3.207, 5.032 and 4.554, respectively (all <0.05). After adjustment for the potentially confounding variables, the adjusted OR values of the third and fourth quartile group had no obvious change. The results of ROC showed that the plasma CTGF had the largest area under the ROC curve, and the value was 0.659 ( = 0.005).
The level of circulating plasma CTGF in the LV diastolic dysfunction group was significantly increased. Plasma CTGF level is an independent risk factor for LV diastolic dysfunction. Compared with serum BNP level, the plasma CTGF level may have auxiliary diagnostic value for LV diastolic dysfunction in hyperthyroid patients.
左心室舒张功能障碍是未来心血管事件的独立预测因素。早期发现左心室舒张功能障碍患者可通过积极管理改善临床结局。然而，舒张功能的评估非常复杂，目前缺乏有效的生物标志物来评估左心室舒张功能障碍的风险。结缔组织生长因子（CTGF）在心脏重塑和功能障碍中起重要作用。本研究旨在探讨血浆CTGF水平与左心室舒张功能障碍风险之间的关联，并判断其在诊断左心室舒张功能障碍中的有效性。
共纳入169例显性甲状腺功能亢进患者。评估左心室舒张功能，并将受试者分为左心室舒张功能正常组和左心室舒张功能障碍组。记录常规临床医疗数据、生化数据、甲状腺相关参数和超声心动图参数进行分析。
与左心室舒张功能正常组相比，左心室舒张功能障碍组年龄和BMI更高，心率更低，血清白蛋白更低，估算肾小球滤过率（eGFR）更低，血清甲状腺球蛋白抗体（TgAb）和脑钠肽（BNP）水平更高，高血压发生率也更高（均P<0.05）。左心室舒张功能障碍组循环血浆CTGF水平显著更高（左心室舒张功能正常组：7.026[5.567-8.895]，左心室舒张功能障碍组：8.290[7.054-9.225]ng/ml，中位数[四分位数间距]，P=0.004）；与最低四分位数组相比，第二、第三和第四四分位数组左心室舒张功能障碍的粗比值比（OR）分别为3.207、5.032和4.554（均P<0.05）。在对潜在混杂变量进行调整后，第三和第四四分位数组的调整后OR值无明显变化。ROC曲线结果显示，血浆CTGF的ROC曲线下面积最大，值为0.659（P=0.005）。
左心室舒张功能障碍组循环血浆CTGF水平显著升高。血浆CTGF水平是左心室舒张功能障碍的独立危险因素。与血清BNP水平相比，血浆CTGF水平对甲状腺功能亢进患者左心室舒张功能障碍可能具有辅助诊断价值。
