在患有HFrEF的患者中,FGF-23是VR功能障碍和拥堵的生物标志物
Jan Benes1, Katerina Kroupova2,3, Martin Kotrc2
1Department of Cardiology, Institute for Clinical and Experimental Medicine-IKEM, Videnska 1958/9, 140 21 Praha 4, Prague, Czech Republic. jan.benes@ikem.cz.
Scientific reports
|September 25, 2023
概括
纤维细胞生长因子23 (FGF-23) 是一种新的生物标志物,用于心力衰竭患者的右心室功能障碍. 这一发现无论拥堵状况如何,都适用,并预测不良结果.
科学领域:
- 心脏病学 心脏病学
- 生物标志物发现发现
- 蛋白质组学是指蛋白质组学.
背景情况:
- 右心室 (RV) 功能障碍在心力衰竭中普遍存在,但缺乏特定的临床生物标志物.
- 目前的临床实践缺乏可靠的循环标记,以反映HFrEF患者的RV功能障碍.
研究的目的:
- 通过使用定量蛋白质组方法,在HFrEF患者中确定VR功能障碍的新型循环生物标志物.
- 验证已识别的生物标志物与VR功能障碍,临床参数和患者结果的关联.
主要方法:
- 使用Olink Multiplex面板进行的定量蛋白质组分析,在HFrEF患者中鉴定出差异丰富的蛋白质,这些患者有严重的RV功能障碍与保存的RV功能.
- 与酶相关的免疫吸收试验 (ELISA) 证实了大量HFrEF队列中的循环纤维细胞生长因子23 (FGF-23) 水平.
- 多变量回归和Cox比例危险模型评估了与VR功能障碍等级,拥堵,左心室喷射率 (LVEF),估计的膜过率 (eGFR),B型尿素 (BNP) 和不良结果的关联.
主要成果:
- 严重VR功能障碍患者的FGF-23显著升高 (超过2.5倍),与保留VR功能患者相比.
- 血FGF-23水平与VR功能障碍等级 (p<0.0004) 和系统性拥堵 (p=0.03) 有很强的相关性,但没有LVEF (p=0.69) 或eGFR (p=0.08).
- 在调整BNP (p=0.01) 后,FGF-23和RV功能障碍之间的关联仍然显著,并且独立于拥堵状态 (p<0.0001). 即使在多变量调整后,FGF-23也预测了不良结果.
结论:
- 在HFrEF患者中,循环FGF-23是VR功能障碍的强有力的生物标志物.
- FGF-23与VR功能障碍严重程度和系统性拥堵有关,独立于LVEF和eGFR.
- 即使考虑到已确立的临床因素,FGF-23也可以作为HFrEF中不良结果的重要预测因子.
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