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在急性心力衰竭患者中肠道炎症和透性的作用
Marcello Covino1, Antonella Gallo2, Noemi Macerola3
1Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.
通过便calprotectin (FC) 测量的肠道炎症是急性心力衰竭 (AHF) 的老年患者不良结果的重要预测因素. 更高的FC水平与更糟糕的预后和更高的NT-proBNP相关,这表明肠心连接.
科学领域:
- 胃肠病学和心脏病学
- 肠心轴研究研究研究
- 在心力衰竭中发现生物标志物
背景情况:
- 心力衰竭 (HF) 构成了重大的健康挑战,治疗结果往往不充分.
- 新出现的证据强调了肠道在高血压病理生理学中的关键作用.
- 在急性HF (AHF) 中,肠道炎症和透性的预后值需要进一步调查.
研究的目的:
- 为了评估肠道炎症和透性在老年患者住院治疗AHF的预后意义.
- 评估肠道标志物与传统的HF诊断和治疗参数之间的相关性.
- 确定AHF患者临床结果的独立预测因子.
主要方法:
- 在2022年4月至2023年4月期间入院的59名AHF患者的前性,纵向,单中心研究.
- 评估了血清实验室参数,心声学,便calprotectin (FC) 对于肠道炎症,和zonulin (血清/便) 对于透性.
- 临床结局定义为90天的AHF再住院和/或所有原因死亡率.
主要成果:
- 较高的FC水平 (>50μg/g) 与显著更差的临床结果 (p < 0.001) 和较高的NT-proBNP (p < 0.05) 相关.
- 在患有较高FC值 (p <0.05) 的患者中,观察到中位数TAPSE (三 annular平面缩外流) 的较低值.
- 多变量分析确定高NT-proBNP和FC> 50μg/g作为不良结果的独立预测指标; zonulin水平没有显著的相关性.
结论:
- 这项研究支持AHF中强烈的肠心轴连接,便calprotectin作为独立的预后标志物出现.
- 用FC表示的肠道炎症是老年AHF患者的有价值的预后指标.
- 需要进一步的研究来验证这些发现,并探索肠道向疗法,特别是对于脆弱的老年患者.
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