Thakshani Wimalanathan, Michael Fredrik Paus, Julia Brox Skranes, Trygve Berge, Arnljot Tveit, Helge Røsjø, Torbjørn Omland, Magnus Nakrem Lyngbakken, Siri Lagethon Heck
{"title":"生长分化因子15、心肌肌钙蛋白T和n端前b型利钠肽与心脏磁共振成像评估的未来心肌纤维化之间的关系：来自1950年Akershus心脏检查研究的数据。","authors":"Thakshani Wimalanathan, Michael Fredrik Paus, Julia Brox Skranes, Trygve Berge, Arnljot Tveit, Helge Røsjø, Torbjørn Omland, Magnus Nakrem Lyngbakken, Siri Lagethon Heck","doi":"10.1093/jalm/jfae145","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is associated with a poor outcome for patients with cardiovascular disease (CVD). Growth differentiation factor 15 (GDF-15) concentrations predict the risk of death in patients with CVD, but the underlying pathophysiological mechanisms are poorly understood. We aimed to assess the associations between biomarkers of cellular stress and inflammation (GDF-15), cardiac injury (cardiac troponin T [cTnT]), and stretch (N-terminal pro-B-type natriuretic peptide [NT-proBNP]), and subsequent focal and diffuse myocardial fibrosis assessed by cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>We measured GDF-15, cTnT, and NT-proBNP in 200 study participants without known coronary artery disease or renal dysfunction from the population-based Akershus Cardiac Examination 1950 Study at baseline in 2012 to 2015. Focal myocardial scars and diffuse fibrosis were assessed by late gadolinium enhancement imaging and septal extracellular volume fraction (ECV) by CMR 4 to 7 years later. The relationships between cardiac biomarkers and CMR parameters were assessed by logistic regression analysis adjusted for common cardiovascular risk factors.</p><p><strong>Results: </strong>The median age was 63.9 (interquartile range 63.4-64.5) years and 49% were women. GDF-15 (adjusted odds ratio [aOR] 4.40, 95% CI 1.09-17.72) and cTnT (aOR 1.59, 95% CI 1.01-2.50) were associated with nonischemic scars in the fully adjusted model. cTnT (aOR 2.45, 95% CI 1.41-4.25) and NT-proBNP (aOR 3.12, 95% CI 1.55-6.28) were associated with ischemic scars. None of the biomarkers were significantly associated with elevated ECV.</p><p><strong>Conclusions: </strong>In a general population cohort, GDF-15, an emerging biomarker of cellular stress and inflammation, associates with nonischemic scars. Biomarkers of myocardial injury and stretch associate with ischemic scars, while no biomarker was associated with diffuse fibrosis as assessed by CMR.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations between Growth Differentiation Factor 15, Cardiac Troponin T, and N-terminal pro-B-type Natriuretic Peptide, and Future Myocardial Fibrosis Assessed by Cardiac Magnetic Resonance Imaging: Data from the Akershus Cardiac Examination 1950 Study.\",\"authors\":\"Thakshani Wimalanathan, Michael Fredrik Paus, Julia Brox Skranes, Trygve Berge, Arnljot Tveit, Helge Røsjø, Torbjørn Omland, Magnus Nakrem Lyngbakken, Siri Lagethon Heck\",\"doi\":\"10.1093/jalm/jfae145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Myocardial fibrosis is associated with a poor outcome for patients with cardiovascular disease (CVD). Growth differentiation factor 15 (GDF-15) concentrations predict the risk of death in patients with CVD, but the underlying pathophysiological mechanisms are poorly understood. We aimed to assess the associations between biomarkers of cellular stress and inflammation (GDF-15), cardiac injury (cardiac troponin T [cTnT]), and stretch (N-terminal pro-B-type natriuretic peptide [NT-proBNP]), and subsequent focal and diffuse myocardial fibrosis assessed by cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>We measured GDF-15, cTnT, and NT-proBNP in 200 study participants without known coronary artery disease or renal dysfunction from the population-based Akershus Cardiac Examination 1950 Study at baseline in 2012 to 2015. Focal myocardial scars and diffuse fibrosis were assessed by late gadolinium enhancement imaging and septal extracellular volume fraction (ECV) by CMR 4 to 7 years later. The relationships between cardiac biomarkers and CMR parameters were assessed by logistic regression analysis adjusted for common cardiovascular risk factors.</p><p><strong>Results: </strong>The median age was 63.9 (interquartile range 63.4-64.5) years and 49% were women. GDF-15 (adjusted odds ratio [aOR] 4.40, 95% CI 1.09-17.72) and cTnT (aOR 1.59, 95% CI 1.01-2.50) were associated with nonischemic scars in the fully adjusted model. cTnT (aOR 2.45, 95% CI 1.41-4.25) and NT-proBNP (aOR 3.12, 95% CI 1.55-6.28) were associated with ischemic scars. None of the biomarkers were significantly associated with elevated ECV.</p><p><strong>Conclusions: </strong>In a general population cohort, GDF-15, an emerging biomarker of cellular stress and inflammation, associates with nonischemic scars. Biomarkers of myocardial injury and stretch associate with ischemic scars, while no biomarker was associated with diffuse fibrosis as assessed by CMR.</p>\",\"PeriodicalId\":46361,\"journal\":{\"name\":\"Journal of Applied Laboratory Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-12-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Applied Laboratory Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/jalm/jfae145\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Applied Laboratory Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jalm/jfae145","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：心肌纤维化与心血管疾病（CVD）患者预后不良相关。生长分化因子15 （GDF-15）浓度可预测心血管疾病患者的死亡风险，但其潜在的病理生理机制尚不清楚。我们的目的是评估细胞应激和炎症（GDF-15）、心脏损伤（心肌肌钙蛋白T [cTnT]）和拉伸（n端前b型利钠肽[NT-proBNP]）的生物标志物之间的关系，以及随后通过心脏磁共振（CMR）成像评估的局灶性和弥漫性心肌纤维化。方法：我们在2012年至2015年以人群为基础的Akershus心脏检查1950研究中测量了200名无已知冠状动脉疾病或肾功能不全的研究参与者的GDF-15、cTnT和NT-proBNP。局灶性心肌疤痕和弥漫性纤维化在4 ~ 7年后通过晚期钆增强成像和CMR的间隔细胞外体积分数（ECV）进行评估。通过调整常见心血管危险因素的logistic回归分析评估心脏生物标志物与CMR参数之间的关系。结果：中位年龄为63.9岁（四分位数差63.4-64.5），女性占49%。在完全调整的模型中，GDF-15（校正优势比[aOR] 4.40, 95% CI 1.09-17.72）和cTnT （aOR 1.59, 95% CI 1.01-2.50）与非缺血性疤痕相关。cTnT （aOR 2.45, 95% CI 1.41-4.25）和NT-proBNP （aOR 3.12, 95% CI 1.55-6.28）与缺血性疤痕相关。没有一项生物标志物与升高的ECV显著相关。结论：在一般人群队列中，GDF-15是一种新兴的细胞应激和炎症生物标志物，与非缺血性疤痕有关。心肌损伤和拉伸的生物标志物与缺血性瘢痕相关，而CMR评估中没有生物标志物与弥漫性纤维化相关。
Associations between Growth Differentiation Factor 15, Cardiac Troponin T, and N-terminal pro-B-type Natriuretic Peptide, and Future Myocardial Fibrosis Assessed by Cardiac Magnetic Resonance Imaging: Data from the Akershus Cardiac Examination 1950 Study.
Background: Myocardial fibrosis is associated with a poor outcome for patients with cardiovascular disease (CVD). Growth differentiation factor 15 (GDF-15) concentrations predict the risk of death in patients with CVD, but the underlying pathophysiological mechanisms are poorly understood. We aimed to assess the associations between biomarkers of cellular stress and inflammation (GDF-15), cardiac injury (cardiac troponin T [cTnT]), and stretch (N-terminal pro-B-type natriuretic peptide [NT-proBNP]), and subsequent focal and diffuse myocardial fibrosis assessed by cardiac magnetic resonance (CMR) imaging.
Methods: We measured GDF-15, cTnT, and NT-proBNP in 200 study participants without known coronary artery disease or renal dysfunction from the population-based Akershus Cardiac Examination 1950 Study at baseline in 2012 to 2015. Focal myocardial scars and diffuse fibrosis were assessed by late gadolinium enhancement imaging and septal extracellular volume fraction (ECV) by CMR 4 to 7 years later. The relationships between cardiac biomarkers and CMR parameters were assessed by logistic regression analysis adjusted for common cardiovascular risk factors.
Results: The median age was 63.9 (interquartile range 63.4-64.5) years and 49% were women. GDF-15 (adjusted odds ratio [aOR] 4.40, 95% CI 1.09-17.72) and cTnT (aOR 1.59, 95% CI 1.01-2.50) were associated with nonischemic scars in the fully adjusted model. cTnT (aOR 2.45, 95% CI 1.41-4.25) and NT-proBNP (aOR 3.12, 95% CI 1.55-6.28) were associated with ischemic scars. None of the biomarkers were significantly associated with elevated ECV.
Conclusions: In a general population cohort, GDF-15, an emerging biomarker of cellular stress and inflammation, associates with nonischemic scars. Biomarkers of myocardial injury and stretch associate with ischemic scars, while no biomarker was associated with diffuse fibrosis as assessed by CMR.
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