Chu Song-Yun, Peng Fen, Wang Jie, Liu Lin, Zhao Jing, Han Xiao-Ning, Ding Wen-Hui
Department of Cardiology, Peking University First Hospital, Beijing, China.
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
ESC Heart Fail. 2025 Feb;12(1):517-524. doi: 10.1002/ehf2.15107. Epub 2024 Oct 3.
Endogenous catecholamine release-inhibitory peptide catestatin has been associated with heart failure (HF). This subgroup analysis of our cohort of HF compared the different effects of catestatin as a predictor for cardiac outcomes in patients with HF with reduced (HFrEF), mildly reduced (HFmrEF) or preserved (HFpEF) ejection fraction.
Plasma catestatin was measured in the HF patient cohort of 228 cases with a whole spectrum of ejection fraction. The cardiac deaths were analysed according to prespecified subgroups.
Over a median follow-up of 52.5 months, the association between plasma catestatin and cardiac death was different in patients with HFrEF, HFmrEF or HFpEF [hazard ratio (HR) 1.53, 95% confidence interval (CI) 0.99-2.37 and HR 2.73, 95% CI 1.56-4.75, respectively; interaction P = 0.022]. Patients with HFmrEF/HFpEF were older and more likely to be female, with non-ischaemic cardiomyopathy and atrial fibrillation but lower levels of plasma B-type natriuretic peptide (BNP). Similar adverse cardiac events occurred in patients with HFmrEF/HFpEF as in HFrEF. Plasma catestatin was a better predictor for cardiovascular death in the HFmrEF/HFpEF patients [area under the receiver operating characteristic curve (AUC) = 0.72, 95% CI 0.45-0.74] than in the HFrEF patients (AUC = 0.59, 95% CI 0.587-0.849). The optimal cut point of plasma catestatin level of 0.86 ng/mL predicted a 2.80-fold elevated risk for cardiac death in HFmrEF/HFpEF.
Elevated plasma catestatin might be a more sensitive predictor for cardiac outcome in patients with HFmrEF/HFpEF than in HFrEF.
内源性儿茶酚胺释放抑制肽抑心肽与心力衰竭（HF）相关。本对HF队列的亚组分析比较了抑心肽作为射血分数降低（HFrEF）、轻度降低（HFmrEF）或保留（HFpEF）的HF患者心脏结局预测指标的不同影响。
对228例具有全谱射血分数的HF患者队列测量血浆抑心肽。根据预先指定的亚组分析心脏死亡情况。
在中位随访52.5个月期间，血浆抑心肽与心脏死亡之间的关联在HFrEF、HFmrEF或HFpEF患者中有所不同[风险比（HR）分别为1.53，95%置信区间（CI）0.99 - 2.37和HR 2.73，95%CI 1.56 - 4.75；交互P = 0.022]。HFmrEF/HFpEF患者年龄更大，更可能为女性，患有非缺血性心肌病和心房颤动，但血浆B型利钠肽（BNP）水平较低。HFmrEF/HFpEF患者发生的不良心脏事件与HFrEF患者相似。血浆抑心肽在HFmrEF/HFpEF患者中对心血管死亡的预测能力[受试者操作特征曲线下面积（AUC）= 0.72，95%CI 0.45 - 0.74]优于HFrEF患者（AUC = 0.59，95%CI 0.587 - 0.849）。血浆抑心肽水平的最佳切点为0.86 ng/mL，预测HFmrEF/HFpEF患者心脏死亡风险升高2.80倍。
与HFrEF患者相比，血浆抑心肽升高可能是HFmrEF/HFpEF患者心脏结局更敏感的预测指标。
