Paula Alexandra Vulciu, Luminita Pilat, Norberth-Istvan Varga, Voicu Dascau, Calin Popa, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Miklos, Maria Puschita
{"title":"四联素作为射血分数为bb0 45%的心力衰竭的潜在生物标志物：一项前瞻性队列研究。","authors":"Paula Alexandra Vulciu, Luminita Pilat, Norberth-Istvan Varga, Voicu Dascau, Calin Popa, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Miklos, Maria Puschita","doi":"10.2478/rjim-2025-0014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Heart failure (HF) with left ventricle ejection fraction (LVEF) >45% lacks reliable biomarkers for risk stratification complicating its management, as it encompasses both heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) and mildly reduced ejection fraction (HFmrEF, LVEF 45-49.9%). This study aimed to evaluate serum tetranectin (TETRA) as a novel biomarker for assessing disease severity and predicting mortality in patients with HF with EF >45%.</p><p><strong>Materials and methods: </strong>In a prospective cohort study including 116 patients HF with EF>45% from a single center in Arad, Romania, stratified by NYHA class (G1: NYHA I, n=48; G2: NYHA II, n=37; G3: NYHA III-IV, n=31), serum TETRA levels were measured using ELISA. Echocardiographic parameters (E/e' ratio, LAVI, LAS, GLS, LVEF) and NT-proBNP were assessed at baseline, with all-cause mortality (9 deaths) tracked over a 12-month follow-up.</p><p><strong>Results: </strong>Median TETRA levels decreased with worsening NYHA class (G1: 48.9 ng/mL, G2: 33.2 ng/mL, G3: 27.6 ng/mL; p < 0.001) and correlated negatively with NT-proBNP (rho = -0.66, p < 0.001), E/e' ratio (rho = -0.58, p = 0.003), and LAVI (rho = -0.52, p = 0.010), while positively correlating with LAS (rho = 0.55, p = 0.005). In univariable Cox analysis, lower TETRA levels were associated with higher all-cause mortality (HR = 1.38 per 10 ng/mL decrease, 95% CI: 1.06-1.81, p = 0.045), but this association was not significant after adjustment for age and NT-proBNP (HR = 1.22, 95% CI: 0.94-1.86, p = 0.112).</p><p><strong>Conclusions: </strong>TETRA levels are inversely associated with severity in heart failure with EF>45% and may reflect disease progression.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"63 3","pages":"251-262"},"PeriodicalIF":0.8000,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tetranectin as a potential biomarker in heart failure with ejection fraction >45%: A prospective cohort study.\",\"authors\":\"Paula Alexandra Vulciu, Luminita Pilat, Norberth-Istvan Varga, Voicu Dascau, Calin Popa, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Miklos, Maria Puschita\",\"doi\":\"10.2478/rjim-2025-0014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Heart failure (HF) with left ventricle ejection fraction (LVEF) >45% lacks reliable biomarkers for risk stratification complicating its management, as it encompasses both heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) and mildly reduced ejection fraction (HFmrEF, LVEF 45-49.9%). This study aimed to evaluate serum tetranectin (TETRA) as a novel biomarker for assessing disease severity and predicting mortality in patients with HF with EF >45%.</p><p><strong>Materials and methods: </strong>In a prospective cohort study including 116 patients HF with EF>45% from a single center in Arad, Romania, stratified by NYHA class (G1: NYHA I, n=48; G2: NYHA II, n=37; G3: NYHA III-IV, n=31), serum TETRA levels were measured using ELISA. Echocardiographic parameters (E/e' ratio, LAVI, LAS, GLS, LVEF) and NT-proBNP were assessed at baseline, with all-cause mortality (9 deaths) tracked over a 12-month follow-up.</p><p><strong>Results: </strong>Median TETRA levels decreased with worsening NYHA class (G1: 48.9 ng/mL, G2: 33.2 ng/mL, G3: 27.6 ng/mL; p < 0.001) and correlated negatively with NT-proBNP (rho = -0.66, p < 0.001), E/e' ratio (rho = -0.58, p = 0.003), and LAVI (rho = -0.52, p = 0.010), while positively correlating with LAS (rho = 0.55, p = 0.005). In univariable Cox analysis, lower TETRA levels were associated with higher all-cause mortality (HR = 1.38 per 10 ng/mL decrease, 95% CI: 1.06-1.81, p = 0.045), but this association was not significant after adjustment for age and NT-proBNP (HR = 1.22, 95% CI: 0.94-1.86, p = 0.112).</p><p><strong>Conclusions: </strong>TETRA levels are inversely associated with severity in heart failure with EF>45% and may reflect disease progression.</p>\",\"PeriodicalId\":21463,\"journal\":{\"name\":\"Romanian Journal of Internal Medicine\",\"volume\":\"63 3\",\"pages\":\"251-262\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Romanian Journal of Internal Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2478/rjim-2025-0014\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Romanian Journal of Internal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2478/rjim-2025-0014","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的：左心室射血分数（LVEF）低于45%的心力衰竭（HF）缺乏可靠的风险分层生物标志物，使其管理复杂化，因为它包括射血分数保留的心力衰竭（HFpEF, LVEF≥50%）和轻度降低的射血分数（HFmrEF, LVEF 45-49.9%）。本研究旨在评估血清四联素（TETRA）作为评估疾病严重程度和预测心力衰竭患者死亡率的一种新的生物标志物。材料和方法：在一项前瞻性队列研究中，来自罗马尼亚Arad单一中心的116例HF伴EF bb0 45%的患者，按NYHA分级（G1: NYHA I, n=48; G2: NYHA II, n=37; G3: NYHA III-IV, n=31），采用ELISA检测血清TETRA水平。在基线时评估超声心动图参数（E/ E比值、LAVI、LAS、GLS、LVEF）和NT-proBNP，并在12个月的随访中跟踪全因死亡率（9例死亡）。结果：TETRA中位水平随NYHA分级加重而降低（G1: 48.9 ng/mL, G2: 33.2 ng/mL, G3: 27.6 ng/mL, p < 0.001），与NT-proBNP （rho = -0.66, p < 0.001）、E/ E′比（rho = -0.58, p = 0.003）、LAVI （rho = -0.52, p = 0.010）呈负相关，与LAS呈正相关（rho = 0.55, p = 0.005）。在单变量Cox分析中，较低的TETRA水平与较高的全因死亡率相关（每降低10 ng/mL， HR = 1.38, 95% CI: 1.06-1.81, p = 0.045），但在调整年龄和NT-proBNP后，这种关联不显著（HR = 1.22, 95% CI: 0.94-1.86, p = 0.112）。结论：TETRA水平与心力衰竭的严重程度呈负相关，EF bb0为45%，可能反映疾病进展。
Tetranectin as a potential biomarker in heart failure with ejection fraction >45%: A prospective cohort study.
Background and objectives: Heart failure (HF) with left ventricle ejection fraction (LVEF) >45% lacks reliable biomarkers for risk stratification complicating its management, as it encompasses both heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) and mildly reduced ejection fraction (HFmrEF, LVEF 45-49.9%). This study aimed to evaluate serum tetranectin (TETRA) as a novel biomarker for assessing disease severity and predicting mortality in patients with HF with EF >45%.
Materials and methods: In a prospective cohort study including 116 patients HF with EF>45% from a single center in Arad, Romania, stratified by NYHA class (G1: NYHA I, n=48; G2: NYHA II, n=37; G3: NYHA III-IV, n=31), serum TETRA levels were measured using ELISA. Echocardiographic parameters (E/e' ratio, LAVI, LAS, GLS, LVEF) and NT-proBNP were assessed at baseline, with all-cause mortality (9 deaths) tracked over a 12-month follow-up.
Results: Median TETRA levels decreased with worsening NYHA class (G1: 48.9 ng/mL, G2: 33.2 ng/mL, G3: 27.6 ng/mL; p < 0.001) and correlated negatively with NT-proBNP (rho = -0.66, p < 0.001), E/e' ratio (rho = -0.58, p = 0.003), and LAVI (rho = -0.52, p = 0.010), while positively correlating with LAS (rho = 0.55, p = 0.005). In univariable Cox analysis, lower TETRA levels were associated with higher all-cause mortality (HR = 1.38 per 10 ng/mL decrease, 95% CI: 1.06-1.81, p = 0.045), but this association was not significant after adjustment for age and NT-proBNP (HR = 1.22, 95% CI: 0.94-1.86, p = 0.112).
Conclusions: TETRA levels are inversely associated with severity in heart failure with EF>45% and may reflect disease progression.
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