在心房动中基于血液的心脏代谢表型及其相关风险:EAST-AFNET 4生物分子研究
Larissa Fabritz1,2,3,4,5, Winnie Chua5, Victor R Cardoso5
1Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Cardiovascular research
|April 13, 2024
概括
生物分子模式识别出不同的心房动 (AF) 患者群体,揭示出不同的心血管风险. 这些心脏代谢亚表型有助于对患者进行分层,以更好地评估和管理风险.
科学领域:
- 心脏病学和精准医学 精准医学
- 生物标志物发现发现
- 心房动病理生理学
背景情况:
- 心房动 (AF) 经常与心脏代谢疾病共存,增加中风,心力衰竭和心血管死亡的风险.
- 循环中的生物分子作为潜在心脏代谢过程的可量化的指标.
- 在AF中识别不同的患者亚组对于个性化风险分层至关重要.
研究的目的:
- 调查循环生物分子的组合是否可以在心房动 (AF) 患者中定义不同的心脏代谢表型.
- 评估与这些已识别的AF亚表型相关的心血管事件率.
- 在一个独立的队列中验证已识别的表型及其相关风险.
主要方法:
- 在EAST-AFNET 4研究中的1586名患者中,使用了13个生物分子的基线度进行了潜在类分析.
- 生物分子反映了包括衰老,心脏纤维化,代谢功能障碍,炎症和心脏负荷在内的过程.
- 心血管事件率在已识别的集群中进行了比较,在未来的BBC-AF队列中进行了验证.
主要成果:
- 在无监督分析中,根据生物分子概况,确定了四个不同的AF患者群 (亚表型).
- 风险最高的群体表现出高水平的特定生物分子 (例如,BMP10,IGFBP7,NT-proBNP,Ang-2,GDF-15),与风险最低的群体相比,心血管事件发生率高出五倍.
- 中级风险集群通过炎症标志物 (CRP,IL-6) 和凝血标志物 (D-二次体) 来区分;早期节律控制在所有已识别的亚现型中都是有效的.
结论:
- 循环生物分子度有效地识别了与心房动 (AF) 患者不同的心脏代谢亚表型.
- 这些亚现象与心血管风险的显著差异相关,使得患者的分层更好.
- 这些发现支持使用生物分子分析来进行AF管理中的个性化风险评估.
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