心脏素I与血液动力学受损,左心室进展性功能障碍和晚期心力衰竭中死亡率增加有关
Tamara B Horwich1, Jignesh Patel, W Robb MacLellan
1Ahmanson-UCLA Cardiomyopathy Center, UCLA Division of Cardiology, 47-123 CHS, 10833 Le Conte Ave, Los Angeles, Calif 90095-1679, USA.
Circulation
|August 13, 2003
概括
在严重心力衰竭 (HF) 中心肌素I (cTnI) 的升高表明血液动力学状况较差,并预测死亡风险增加. 将cTnI与B型尿素 (BNP) 结合起来,进一步提高了HF患者的预后价值.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 心脏衰竭研究研究
背景情况:
- 心脏素I (cTnI) 是心肌损伤的关键标志物,有助于在急性冠状动脉综合征的诊断和预后.
- 新出现的证据表明,严重心力衰竭 (HF) 中cTnI升高可能预测不良结果.
研究的目的:
- 评估在晚期心力衰竭中cTnI水平和临床参数之间的关联.
- 为了确定cTnI是否预测晚期HF患者的死亡风险.
主要方法:
- 在238名被转诊进行心脏移植的高级HF患者中评估了cTnI水平.
- 排除了急性心肌梗塞或心肌炎的患者.
- 与B型尿素 (BNP),血液动力学概况和射出分数相关的cTnI.
主要成果:
- 可检测的cTnI (≥0.04 ng/mL) 在49.1%的患者中被发现.
- 可检测的cTnI与较高的BNP相关,血液动力学受损 (较高的肺压力,较低的心脏指数) 和射出率下降.
- 可检测的cTnI独立地与2.05倍的死亡风险增加有关.
- 结合cTnI和BNP改善了预后价值.
结论:
- cTnI与血液动力学损害,BNP升高,以及HF中心室功能障碍恶化有关.
- cTnI可以作为一种新的生物标志物,用于识别高风险HF患者.
- cTnI,特别是与BNP一起,在先进的高频率中提供了有价值的预后信息.
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