Huma Laurentiu, Suciu Horatiu, Avram Calin, Suteu Radu-Adrian, Danilesco Alina, Baba Dragos-Florin, Moldovan Diana-Andreea, Sin Anca-Ileana
Department of Cell and Molecular Biology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania.
J Clin Med. 2024 Dec 8;13(23):7466. doi: 10.3390/jcm13237466.
: Heart transplant is the final therapeutic option for end-stage heart failure patients. It has been used with increasing success as a surgical procedure, greatly influenced by advances in diagnostic and prognostic tools. The aim of this paper was to study potential implications of C-reactive protein (CRP) in patients who underwent heart transplants. : Our cohort included 43 adult patients from the Emergency Institute for Cardiovascular Diseases and Transplant of Târgu Mureș who underwent heart transplants in our center between 2011 and 2023. Correlations between CRP levels and different characteristics of the patients were investigated, and the optimal cut-off value for CRP levels in relation to the 6-month mortality rate was determined. The central tendencies of the baseline characteristics of patients who had a CRP value lower than the cut-off and those with a value higher than it were compared using parametric or nonparametric tests. : Significant correlations between the preoperative CRP levels and 6-month mortality rate (r = 0.35; 95%CI: 0.05-0.60; = 0.02), as well as previous cardiac resynchronization therapy (CRT) and preoperative CRP levels (r = -0.37; 95%CI: -0.61--0.07, = 0.01) were highlighted. A value for CRP > 1.66 mg/dL was found to be associated with 6-month mortality (OR = 18.00; 95%CI: 1.90-170.33, < 0.01). Moreover, the patients who received CRT before transplantation had significantly lower levels of CRP when compared to those who did not receive CRT ( = 0.01). : Preoperative CRP levels could represent a valuable asset in the follow-up algorithm of heart transplant patients. The lower levels of CRP in patients who benefited from CRT before transplantation highlights the importance of understanding the complex mechanisms of inflammation and increasing focus on device therapy for future transplant recipients. Further prospective studies with larger cohorts are needed for validation.
心脏移植是终末期心力衰竭患者的最终治疗选择。作为一种外科手术，其应用越来越成功，这在很大程度上受到诊断和预后工具进步的影响。本文旨在研究C反应蛋白（CRP）在接受心脏移植患者中的潜在影响。
我们的队列包括43名来自特尔古穆列什心血管疾病与移植急救研究所的成年患者，他们于2011年至2023年在我们中心接受了心脏移植。研究了CRP水平与患者不同特征之间的相关性，并确定了与6个月死亡率相关的CRP水平的最佳临界值。使用参数检验或非参数检验比较了CRP值低于临界值和高于临界值的患者基线特征的集中趋势。
术前CRP水平与6个月死亡率之间存在显著相关性（r = 0.35；95%CI：0.05 - 0.60；P = 0.02），以及先前的心脏再同步治疗（CRT）与术前CRP水平之间也存在显著相关性（r = -0.37；95%CI：-0.61 - -0.07，P = 0.01）。发现CRP>1.66 mg/dL的值与6个月死亡率相关（OR = 18.00；95%CI：1.90 - 170.33，P < 0.01）。此外，与未接受CRT的患者相比，移植前接受CRT的患者CRP水平显著更低（P = 0.01）。
术前CRP水平可能是心脏移植患者随访算法中的一项有价值的指标。移植前从CRT中获益的患者CRP水平较低，这凸显了理解炎症复杂机制以及更加关注未来移植受者的器械治疗的重要性。需要进一步进行更大队列的前瞻性研究以进行验证。
