III型プロコラーゲンの血清アミノ端末プロペプチドと,急性心筋梗塞後の左心室機能の変化との関連
S H Poulsen1, N B Høst, S E Jensen
1Department of Internal Medicine, Division of Cardiology, Haderslev Hospital, Haderslev, Denmark.
Circulation
|April 4, 2000
まとめ
心筋梗塞 (MI) の後のIII型プロコラーゲン (PIIINP) のアミノ末端プロペプチドレベルは,左心室 (LV) の長期的な機能を予測します. PIIINPの上昇は,LVの改造が悪くなり,心筋梗塞患者の予後が悪いことを示している.
科学分野:
- 心臓病学 心臓病学
- バイオマーカー バイオマーカー
- コラーゲンの代謝
背景:
- III型プロコラーゲンのアミノ末端プロペプチド (PIIINP) は,III型コラーゲンの合成を反映しています.
- PIIINPは,心筋梗塞 (MI) の心筋梗塞の大きさと予後と相関しています.
研究 の 目的:
- PIIINP濃度と,急性心筋梗塞後の左心室 (LV) 機能の長期的な変化との関係を調査する.
- PIIINPの予後値を評価し,MI後の不良心事象を予測する.
主な方法:
- 血清PIIINPレベルは47人の初発急性心筋梗塞患者と16人の対照群で測定されました.
- LVの機能は360日間のエコーカルディオグラフィによって評価されました.
- 患者は4日目のPIIINPレベル (<=5.0マイクログラム/L対>5.0マイクログラム/L) に基づいて2つのグループに分類されました.
主要な成果:
- PIIINP (>5.0μg/L) が高かった患者は,LVエジェクション分数の有意な改善と,LV体積の増加を示さなかった.
- より高いPIIINPレベルは,制限的なLVダイアストリック充填と関連していました.
- 増加したPIIINPと特定の減速時間は,独立して心臓死または心不全を予測した.
結論:
- MIの亜急性期で測定されたPIIINPは,長期的なLV機能と関連しています.
- PIIINPは,心臓発作後の患者のための貴重な臨床予後マーカーとして機能します.
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