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脂质运载蛋白-2在先天性心脏病相关肺动脉高压中的独立预后价值

Independent prognostic value of lipocalin-2 in congenital heart disease-associated pulmonary artery hypertension.

作者信息

Guo Zhang-Ke, Chen Ping-Gui, Li Yao-Xuan, Jiao Hong, Kong Xiao-Hui, Bai Song, Li Xiao-Feng, Liu Ai-Jun, Wang Guo-Liang

机构信息

Department of Cardiac Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

Department of General Surgery, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China.

出版信息

World J Cardiol. 2024 Dec 26;16(12):720-730. doi: 10.4330/wjc.v16.i12.720.

Abstract

BACKGROUND

Timely and accurate evaluation of the patient's pulmonary arterial pressure (PAP) is of great significance for the treatment of congenital heart disease. Currently, there is no non-invasive gold standard method for evaluating PAP.

AIM

To assess the prognostic value of lipocalin-2 (LCN2) in relation to PAP in patients with congenital heart disease associated with pulmonary artery hypertension.

METHODS

We conducted a retrospective analysis of 69 pediatric patients diagnosed with ventricular septal defects. The patients' clinical and laboratory data were collected. The serum LCN2 concentrations were compared between the pulmonary arterial hypertension (PAH) group and the nonPAH group. The correlation of LCN2 concentration with PAH classification was evaluated using binary logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic potential of LCN2 for PAH.

RESULTS

Serum LCN2 concentration significantly correlated with patients' mean PAP ( = 0.544, < 0.001), but not correlated with creatinine ( = 0.446) or blood urea nitrogen ( = 0.747). LCN2 levels were significantly correlated with PAH in both univariate [odds ratio (OR) 1.107, 95%CI: 1.033-1.185, = 0.004)] and multivariate regression analysis (OR 1.150, 95%CI: 1.027-1.288, = 0.015). ROC curve analysis revealed an area under the curve of 0.783 for LCN2. At the cutoff value of 19.42 ng/mL, the sensitivity and specificity of LCN2 for diagnosing PAH is 90.19% and 55.56%, respectively. LCN2 concentration also significantly correlated with the post-repair mean PAP in patients with congenital heart disease ( = 0.532, = 0.009).

CONCLUSION

LCN2 is emerging as a candidate biomarker for assessing PAP in patients with congenital heart disease. Its high sensitivity in diagnosing PAH makes it a valuable tool in patient management.

摘要

背景

及时、准确地评估患者的肺动脉压(PAP)对于先天性心脏病的治疗具有重要意义。目前,尚无评估PAP的非侵入性金标准方法。

目的

评估脂质运载蛋白-2(LCN2)在先天性心脏病合并肺动脉高压患者中与PAP的预后价值。

方法

我们对69例诊断为室间隔缺损的儿科患者进行了回顾性分析。收集患者的临床和实验室数据。比较肺动脉高压(PAH)组和非PAH组的血清LCN2浓度。采用二元逻辑回归分析评估LCN2浓度与PAH分级的相关性。采用受试者工作特征(ROC)曲线评估LCN2对PAH的诊断潜力。

结果

血清LCN2浓度与患者平均PAP显著相关(r = 0.544,P < 0.001),但与肌酐(r = 0.446)或血尿素氮(r = 0.747)无关。在单因素[比值比(OR)1.107,95%CI:1.033 - 1.185,P = 0.004]和多因素回归分析(OR 1.150,95%CI:1.027 - 1.288,P = 0.015)中,LCN2水平均与PAH显著相关。ROC曲线分析显示LCN2的曲线下面积为0.783。在截断值为19.42 ng/mL时,LCN2诊断PAH的敏感性和特异性分别为90.19%和55.56%。LCN2浓度也与先天性心脏病患者修复后的平均PAP显著相关(r = 0.532,P = 0.009)。

结论

LCN2正在成为评估先天性心脏病患者PAP的候选生物标志物。其在诊断PAH方面的高敏感性使其成为患者管理中的一种有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ed5/11669969/12f5d40f20e3/WJC-16-720-g001.jpg

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