内分泌蛋白,一种由原VI形成而产生的,用于心力衰竭
Julio A Chirinos1,2, Lei Zhao3, Alexander L Reese-Petersen4
1Hospital of the University of Pennsylvania, Philadelphia.
NEJM evidence
|August 30, 2023
概括
循环内分泌蛋白水平与心力衰竭 (HF) 患者的恶化结果有关. 这种可以独立地预测死亡和住院,特别是在具有保留喷射分数 (HFpEF) 的高中.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 心脏衰竭病理生理学 病理生理学
背景情况:
- 在动物模型中,由VI型原蛋白衍生出的类固醇 (endotrophin) 与代谢失调,炎症和纤维化有关.
- 它在人类心力衰竭 (HF) 中的作用以前没有被调查过.
研究的目的:
- 检查循环内分泌蛋白水平与HF患者的临床结果之间的关联.
- 通过多个队伍验证这些发现,包括具有保留射出分数 (HFpEF) 的HF和具有减少射出分数 (HFrEF) 的HF.
主要方法:
- 对TOPCAT试验 (HFpEF) 参与者的内分泌素水平的分析.
- 通过参与者级别的元分析进行验证,包括HFpEF队列 (PHFS, PEOPLE,血管扩张试验,西班牙队列, TRAINING-HF) 和HFrEF队列 (PHFS).
主要成果:
- 在TOPCAT中,在HFpEF中,基线内分泌蛋白水平与死亡风险增加 (HR=1.74) 和死亡或与HF相关的住院 (DHFA;HR=2.11) 相关.
- 内分泌蛋白改善了风险预测,超出了像MAGGIC得分和NT-proBNP.等既定标记.
- 在HFrEF患者中观察到类似的关联,尽管DHFA的关联强度与MAGGIC得分和BNP相比较低.
结论:
- 循环内分泌蛋白是HF患者,特别是HFpEF患者不良结果的独立预测剂.
- 这些发现突出了内分泌素作为潜在的新生物标志物,用于心力衰竭的风险分层.
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