射血分数减低和保留的心力衰竭患者慢性肾病的临床和蛋白质组学特征

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Geert H.D. Voordes , Adriaan A. Voors , Annabelle Hoegl , Christian T. Madsen , Bart J. van Essen , Wouter Ouwerkerk , Jasper Tromp , Mark A. de la Rambelje , Mads Grønborg , Jan C. Refsgaard , Chim C. Lang , Natasha Barascuk-Michaelsen , Kevin Damman
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引用次数: 0

摘要

背景慢性肾脏病(CKD)在心力衰竭(HF)患者中很普遍,并与不良的临床预后有关。射血分数降低型心力衰竭(HFrEF)和射血分数保留型心力衰竭(HFpEF)患者慢性肾脏病的病理生理学尚未明确。在这项研究中,我们比较了 HFrEF 和 HFpEF 患者的 CKD 临床和蛋白质组学特征。方法我们纳入了苏格兰 BIOSTAT-CHF 队列中的 478 名患者,其中 246 人患有 HFrEF,232 人患有 HFpEF。慢性肾功能衰竭的定义是 eGFR 为 60 mL/min/1.73m2。我们使用逻辑回归和 Cox 回归对伴有 CKD 的 HFrEF 患者和伴有 CKD 的 HFpEF 患者进行了比较。我们使用 6376 种蛋白质进行了差异表达分析。结果在 HFpEF 和 HFrEF 患者中,CKD 患病率分别为 36% 和 32%。CKD患者平均年龄大7岁。体重指数、NT-proBNP、血管紧张素转换酶抑制剂、高密度脂蛋白胆固醇和中风与高频率低密度脂蛋白血症患者的慢性肾脏病相关。在 HFpEF 患者中,CKD 与 MRA 的使用和较高的血小板计数有关。慢性肾功能衰竭与死亡或心衰住院风险增加有关(HR 1.82,p < 0.001),在 HFrEF 和 HFpEF 中效果相似。结论与慢性肾功能衰竭相关的临床特征与慢性肾功能衰竭患者不同。慢性肾功能衰竭与死亡或心力衰竭住院风险的增加有关,但在高频低氧血症和高频低氧血症之间并无差异。HFpEF 和 HFrEF 的慢性肾功能衰竭患者的循环蛋白模式相似,这表明慢性肾功能衰竭的病理生理学没有重大差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and proteomic profiles of chronic kidney disease in heart failure with reduced and preserved ejection fraction

Background

Chronic kidney disease (CKD) is prevalent and related to poor clinical outcomes in patients with heart failure (HF). The pathophysiology of CKD in HF with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF) is not well defined. In this study we compared clinical and proteomic profiles of CKD between patients with HFrEF and HFpEF.

Methods

We included 478 patients of the Scottish BIOSTAT-CHF cohort, of which 246 had HFrEF and 232 had HFpEF. CKD was defined as an eGFR <60 mL/min/1.73m2. We compared HFrEF-patients with CKD to HFpEF-patients with CKD using logistic- and Cox-regression. We performed a differential expression analysis using 6376 proteins.

Results

The prevalence of CKD was 36 % and 32 % in patients with HFpEF and HFrEF, respectively. CKD patients were on average 7 years older. BMI, higher NT-proBNP, ACE-inhibitors, HDL-cholesterol and Stroke were associated with CKD- patients with HFrEF. In HFpEF, CKD was associated with MRA-use and higher platelet count. CKD was associated with increased risk of death or heart failure hospitalization (HR 1.82, p < 0.001), with similar effect in HFrEF and HFpEF. The pattern of differentially expressed proteins between patients with and without CKD was similar in both HF-groups.

Conclusion

Clinical profiles related to CKD- patients with HFrEF were different from CKD-patients with HFrEF. CKD was associated with an increased risk of death or heart failure hospitalization, which was not different between HFpEF and HFrEF. Patterns of circulating proteins were similar between CKD-patients with HFpEF and HFrEF, suggesting no major differences in CKD-pathophysiology.

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CiteScore
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