Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany.
Biomolecules. 2024 Sep 9;14(9):1137. doi: 10.3390/biom14091137.
Dilated cardiomyopathy (DCM) involves myocardial remodeling, characterized by significant fibrosis and extracellular matrix expansion. These changes impair heart function, increasing the risk of heart failure and sudden cardiac death. This study investigates the prognostic value of circulating fibrosis biomarkers as a less invasive method in DCM patients.
Plasma samples from 185 patients with confirmed DCM were analyzed to measure 13 circulating biomarkers using Luminex bead-based multiplex assays and ELISA. The prognostic value of these biomarkers was evaluated concerning heart failure-associated events and all-cause mortality.
Elevated MMP-2 levels (>1519.3 ng/mL) were linked to older age, higher diabetes prevalence, lower HDL, increased NT-proBNP and hs-TnT levels, and severe systolic dysfunction. High TIMP-1 levels (>124.9 ng/mL) correlated with elevated NT-proBNP, more atrial fibrillation, reduced exercise capacity, and larger right ventricles. Increased GDF-15 levels (>1213.9 ng/mL) were associated with older age, systemic inflammation, renal impairment, and poor exercise performance. Elevated OPN levels (>81.7 ng/mL) were linked to higher serum creatinine and NT-proBNP levels. Over a median follow-up of 32.4 months, higher levels of these biomarkers predicted worse outcomes, including increased risks of heart failure-related events and mortality.
Circulating fibrosis biomarkers, particularly MMP-2, TIMP-1, GDF-15, and OPN, are valuable prognostic tools in DCM. They reflect the severity of myocardial remodeling and systemic disease burden, aiding in risk stratification and therapeutic intervention. Integrating these biomarkers into clinical practice could improve DCM management and patient prognosis.
扩张型心肌病（DCM）涉及心肌重构，其特征为显著的纤维化和细胞外基质扩张。这些变化损害了心脏功能，增加了心力衰竭和心源性猝死的风险。本研究旨在探讨循环纤维化生物标志物作为一种较微创方法在 DCM 患者中的预后价值。
分析了 185 例确诊为 DCM 的患者的血浆样本，使用 Luminex 珠基多重分析和 ELISA 测量了 13 种循环生物标志物。评估了这些生物标志物在心衰相关事件和全因死亡率方面的预后价值。
MMP-2 水平升高（>1519.3ng/mL）与年龄较大、糖尿病患病率较高、HDL 较低、NT-proBNP 和 hs-TnT 水平升高以及严重的收缩功能障碍相关。TIMP-1 水平升高（>124.9ng/mL）与 NT-proBNP 升高、更多的心房颤动、运动能力下降和右心室增大相关。GDF-15 水平升高（>1213.9ng/mL）与年龄较大、全身炎症、肾功能损害和运动表现不佳相关。OPN 水平升高（>81.7ng/mL）与血清肌酐和 NT-proBNP 水平升高相关。在中位数为 32.4 个月的随访中，这些生物标志物水平升高预示着预后不良，包括心力衰竭相关事件和死亡风险增加。
循环纤维化生物标志物，特别是 MMP-2、TIMP-1、GDF-15 和 OPN，是 DCM 有价值的预后工具。它们反映了心肌重构和全身疾病负担的严重程度，有助于风险分层和治疗干预。将这些生物标志物纳入临床实践可以改善 DCM 的管理和患者预后。
