Küçük U, Kırılmaz B, Kaya H, Akşit E, Arslan K
Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Hippokratia. 2023 Oct-Dec;27(4):126-131.
Elabela/toddler (ELA-32) is a recently identified endogenous apelin receptor ligand. ELA levels are known to rise in heart failure (HF) patients. However, the association between elevated ELA levels and prognosis in these patients remains unknown. We aimed to investigate whether ELA plasma levels are correlated with prognosis in heart failure patients with reduced ejection fraction (HFrEF).
This case-control cross-sectional study enrolled 150 patients, including 73 HFrEF patients and 77 age- and gender-matched healthy volunteers. We collected a blood sample at hospital admission to measure ELA-32 levels. The study endpoint was cardiovascular mortality or HF-related hospitalization. We followed up all patients in the study for a mean of 7.48 ± 2.73 months.
In patients with HFrEF, ELA-32 levels were higher than those in controls. The levels of ELA-32 showed a significant increase at advanced New York Heart Association stages. In the receiver operating characteristics curve analysis, a cut-off value of the serum ELA-32 level of 8.25 ng/mL showed a sensitivity of 76 % and specificity of 82 % for predicting the study endpoint [area under the curve: 0.84; 95 % confidence interval (CI): 0.72-0.98; p <0.001]. Cardiovascular mortality (p =0.042) and HF-related hospitalization (p <0.001) were statistically more significant in patients with ELA-32 levels greater than 8.25. Age [Hazard ratio (HR) =1.023; 95 % CI: 0.964-1.230, p =0.039], N-terminal pro-brain natriuretic peptide (HR =1.300; 95 % CI: 1.017-1.874, p =0.017), left ventricular end-diastolic volume (HR =1.142; 95 % CI 1.022-1.547, p =0.028), and ELA-32 ≥8.25 (HR =2.556; 95 % CI: 1.078-3.941, p <0.001) remained independently associated with the risk of study endpoint.
For the first time, HF-related hospitalizations and cardiovascular mortality are independently associated with increased ELA-32 levels in patients with HFrEF. HIPPOKRATIA 2023, 27 (4):126-131.
埃拉贝拉/托德林（ELA - 32）是最近发现的一种内源性阿片肽受体配体。已知心力衰竭（HF）患者的ELA水平会升高。然而，这些患者中ELA水平升高与预后之间的关联仍不清楚。我们旨在研究ELA血浆水平与射血分数降低的心力衰竭（HFrEF）患者的预后是否相关。
这项病例对照横断面研究纳入了150名患者，包括73名HFrEF患者和77名年龄及性别匹配的健康志愿者。我们在患者入院时采集血样以测量ELA - 32水平。研究终点是心血管死亡或与HF相关的住院治疗。我们对研究中的所有患者进行了平均7.48±2.73个月的随访。
在HFrEF患者中，ELA - 32水平高于对照组。ELA - 32水平在纽约心脏协会晚期阶段显著升高。在受试者工作特征曲线分析中，血清ELA - 32水平的截断值为8.25 ng/mL时，预测研究终点的敏感性为76%，特异性为82%[曲线下面积：0.84；95%置信区间（CI）：0.72 - 0.98；p<0.001]。ELA - 32水平大于8.25的患者心血管死亡率（p = 0.042）和与HF相关的住院治疗（p<0.001）在统计学上更显著。年龄[风险比（HR）= 1.023；95% CI：0.964 - 1.230，p = 0.039]、N末端脑钠肽前体（HR = 1.300；95% CI：1.017 - 1.874，p = 0.017）、左心室舒张末期容积（HR = 1.142；95% CI 1.022 - 1.547，p = 0.028）以及ELA - 32≥8.25（HR = 2.556；95% CI：1.078 - 3.941，p<0.001）仍然与研究终点风险独立相关。
首次发现与HF相关的住院治疗和心血管死亡率与HFrEF患者ELA - 32水平升高独立相关。《希波克拉底》2023年，27（4）：126 - 131。
