无症状左心室功能障碍患者血诺上腺素的预后意义. 美国SOLVD调查人员
C R Benedict1, B Shelton, D E Johnstone
1Division of Cardiology, University of Texas Medical School, Houston 77030, USA.
Circulation
|August 15, 1996
概括
患有无症状左心室功能障碍的患者血上升的诺尔阿皮内林 (PNE) 水平预测死亡率和临床事件. 测量PNE可能有助于评估疾病进展并指导治疗以获得更好的结果.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 生物标志物 生物标志物
背景情况:
- 神经激素水平升高与症状性心力衰竭的死亡率相关.
- 在无症状的左心室功能障碍 (LVD) 中,早期的神经气激活可能会先于症状.
- 在LVD中早期神经道激活的预后意义需要进一步调查.
研究的目的:
- 在无症状LVD的患者中,评估血诺上腺素 (PNE),心房性尿素 (ANP) 和素活性 (PRA) 的预后值.
- 为了确定这些神经激素是否预测死亡率,心力衰竭的发展,或缺血事件.
主要方法:
- 分析了SOLVD预防试验中514名LVEF≤35%的患者的PNE,ANP和PRA水平.
- 使用了考克斯的比例危险模型,调整了临床因素.
- 检查了所有原因死亡率,心血管死亡率,心力衰竭住院,心力衰竭发展和缺血事件的预测.
主要成果:
- 血诺上腺素 (PNE) 是临床事件的最强预测因子.
- 较高的PNE水平 (>393 pg/mL) 显著增加了所有原因死亡的风险 (RR 2.59),心血管死亡 (RR 2.55),心力衰竭住院治疗 (RR 2.55),心力衰竭的发展 (RR 1.88) 和缺血事件 (RR 1.92).
- 其他神经激素水平并不能显著预测临床事件.
结论:
- 在无症状LVD中增加PNE水平预测死亡率和心力衰竭或急性缺血综合征的发展.
- 测量PNE可以作为LVD疾病进展的早期标志物.
- 调节PNE可能会改善LVD患者的预后并降低LVD患者的发病率.
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