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在心力衰竭患者中,IL-6和hsCRP预测了心血管死亡率,心脏衰竭患者有保存的喷射分数

Martin Berger¹, Winfried März^2,3, Alexander Niessner⁴

¹Department of Internal Medicine I; University Hospital Aachen, RWTH University, Aachen, Germany.

ESC heart failure

|July 14, 2024

概括

升高的互白素-6 (IL-6) 预测了心脏衰竭中心脏衰竭的心脏衰竭与保存的喷射分数 (HFpEF),但不是心脏衰竭的心脏衰竭减少喷射分数 (HFrEF). 这突出了IL-6的特点.

科学领域:

心脏病学心脏病学
生物标志物生物标志物
炎症炎症是一种炎症.

背景情况:

炎症与心力衰竭 (HF) 相关,高的炎症生物标志物与新的HF发病相关.
炎症生物标志物的预后意义可能在具有保留喷射分数 (HFpEF) 的HF和具有减少喷射分数 (HFrEF) 的HF之间有所不同.

研究的目的:

研究炎症,特别是IL-6和高灵敏性C反应蛋白 (hsCRP) 在预测HF患者死亡风险方面的作用.
确定这些生物标志物的预后值是否在HFpEF和HFrEF之间有所不同.

主要方法:

对1086名接受冠状动脉血管造影的患者 (506名HFpEF,580名HFrEF) 的IL-6和hsCRP水平的分析.
使用路德维希沙芬风险和心血管健康研究 (LURIC) 数据对预后价值的评估.
评估IL-6,N终端前脑性尿素 (NT-proBNP) 和遗传IL-6受体变体 (rs2228145) 之间的相互作用.

主要成果:

增加的IL-6水平与高心血管 (CV) 死亡率在HFpEF (HR 1.5,P=0.018) 中显著相关,但在HFrEF (HR 1.3,P=0.06) 中没有.
hsCRP表现出类似的趋势,但在完全调整后没有达到统计显著性.
相互作用分析显示,在HFpEF (P=0.036),但不是HFrEF (P=0.220) 中IL-6和NT-proBNP升高的情况下,心血管死亡率逐步增加.
具有HFpEF的IL6-受体变异rs2228145的同卵性载体具有显著较低的NT-proBNP水平,这表明IL-6信号在HFpEF中起着病理生理学作用.

结论:

升高的IL-6水平对心血管死亡率具有预测价值,特别是在HFpEF患者中.
这些发现表明,与HFrEF相比,IL-6信号可能在HFpEF中发挥着独特的病理生理学作用.

关键词:

心脏衰竭是因为心脏衰竭.心力衰竭与保存的喷射分数的心脏衰竭心力衰竭与减少的喷射分数心力衰竭高灵敏度的CRP具有很高的灵敏度.互白素-6 的作用.

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