流星蛋白样蛋白血浆水平与新发心力衰竭的不良预后相关。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Laura Anido-Varela, Alana Aragón-Herrera, Adrián González-Maestro, Carlos Tilves Bellas, Estefanía Tarazón, Eduard Solé-González, Manuel Martínez-Sellés, José María Guerra-Ramos, Anna Carrasquer, Laura Morán-Fernández, David García-Vega, Ana Seoane-Blanco, María Moure-González, Jose Seijas-Amigo, Diego Rodríguez-Penas, Javier García-Seara, Sandra Moraña-Fernández, Xocas Vázquez-Abuín, Esther Roselló-Lletí, Manuel Portolés, Sonia Eiras, Rosa M Agra, Ezequiel Álvarez, José R González-Juanatey, Sandra Feijóo-Bandín, Francisca Lago
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引用次数: 0

摘要

背景与目的:流星蛋白样蛋白(Metrnl)最近被认为是一种具有心血管保护作用的新型脂肪因子。其在患者体内的循环水平似乎与心力衰竭(HF)有关,尽管结果相互矛盾。我们的目的是确定这种脂肪因子是否可以估计新发HF (DNHF)患者的预后。方法:采用酶联免疫吸附法测定400例DNHF住院患者(55%的HF伴射血分数降低,17.3%的HF伴射血分数中程,27.8%的HF伴射血分数保留)血浆中Metrnl水平。我们进行了性别汇总分析和性别特异性分析。随访12个月,收集全因死亡率、心血管死亡和心衰再住院等临床结果。结果:随访12个月后,经性别、年龄、LVEF、高血压、糖尿病、缺血性病因、慢性肾衰竭、NT-proBNP和肌钙蛋白校正后,血浆中较高的Metrnl水平与全因死亡和心血管死亡风险增加相关(危险比[HR] = 1.003, 95%可信区间[CI] = 1.000-1.005;结论:高水平的metnl患者DNHF预后较差。我们的研究结果强化了血浆中Metrnl水平与HF进展和结局的关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Meteorin-like protein plasma levels are associated with worse outcomes in de novo heart failure.

Background and aims: Meteorin-like protein (Metrnl) has been recently suggested as a new adipokine with protective cardiovascular effects. Its circulating levels in patients seem to be associated with heart failure (HF), although with contradictory results. Our aim was to ascertain whether this adipokine could estimate the prognosis of HF in de novo HF (DNHF) patients.

Methods: Metrnl plasma levels of 400 patients hospitalized with DNHF (55% of patients with HF with reduced ejection fraction, 17.3% HF with mid-range ejection fraction, 27.8% HF with preserved ejection fraction) were measured by enzyme-linked immunosorbent assay. We performed both sex-pooled and sex-specific analyses. A 12-month follow-up was conducted, during which clinical outcomes such as all-cause mortality, cardiovascular death and re-hospitalization due to HF were collected.

Results: After a 12-month follow up, higher plasma Metrnl levels were associated with an increased risk for all-cause death and cardiovascular death after adjusting by sex, age, LVEF, hypertension, diabetes, ischemic aetiology, chronic renal failure, NT-proBNP and troponin (hazard ratio [HR] = 1.003, 95% confidence interval [CI] = 1.000-1.005; p-value<.05 and HR = 1.004, 95% CI = 1.001-1.007, p-value<.05, respectively). In line with this, DNHF patients with increased levels of circulating Metrnl had a higher number of occurrences of cardiovascular events. Regarding Metrnl associations with parameters implicated in the development and progression of HF, we found that Metrnl circulating levels were positively correlated with age (r = .322, p-value<.0001), NT-proBNP (r = .281, p-value<.0001) and with the renal dysfunction markers urea (r = .322, p-value<.0001) and creatinine (r = .353, p-value<.0001) and higher in women than men (473.7 [385.9-594.0] pg/mL vs. 428.7 [349.1-561.3] pg/mL, p-value<.006). Finally, concerning the subtype of HF, Metrnl plasma levels were higher in HF with preserved ejection fraction.

Conclusion: Patients with higher Metrnl levels have a worse prognosis in DNHF. Our results reinforce the association of Metrnl plasma levels with HF progression and outcomes.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
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期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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