T. Dschietzig, K. Kellner, K. Sasse, F. Boschann, R. Klüsener, J. Ruppert, F. Armbruster, D. Bankovic, A. Meinitzer, V. Mitrović, C. Melzer
{"title":"血浆犬尿氨酸可预测心力衰竭的严重程度和并发症,并与已建立的疾病生化和临床标志物相关","authors":"T. Dschietzig, K. Kellner, K. Sasse, F. Boschann, R. Klüsener, J. Ruppert, F. Armbruster, D. Bankovic, A. Meinitzer, V. Mitrović, C. Melzer","doi":"10.1159/000501483","DOIUrl":null,"url":null,"abstract":"Background: Kynurenine, a metabolite of the L-tryptophan pathway, plays a pivotal role in neuro-inflammation, cancer immunology, and cardiovascular inflammation, and has been shown to predict cardiovascular events. Objectives: It was our objective to increase the body of data regarding the value of kynurenine as a biomarker in chronic heart failure (CHF). Methods: We investigated the predictive value of plasma kynurenine in a CHF cohort (CHF, n = 114); in a second cohort of defibrillator carriers with CHF (AICD, n = 156), we determined clinical and biochemical determinants of the marker which was measured by enzyme immunoassay. Results: In the CHF cohort, both kynurenine and NT-proBNP increased with NYHA class. Univariate binary logistic regression showed kynurenine to predict death within a 6-month follow-up (OR 1.43, 95% CI 1.03–2.00, p = 0.033) whereas NT-proBNP did not contribute significantly. Kynurenine, like NT-proBNP, was able to discriminate at a 30% threshold of left ventricular ejection fraction (LVEF; AUC-ROC, both 0.74). Kynurenine correlated inversely with LVEF (ϱ = –0.394), glomerular filtration fraction (GFR; ϱ = –0.615), and peak VO2 (ϱ = –0.626). Moreover, there was a strong correlation of kynurenine with NT-proBNP (ϱ = 0.615). In the AICD cohort, multiple linear regression analysis demonstrated highly significant associations of kynurenine with GFR, hsCRP, and tryptophan, as well as a significant impact of age. Conclusions: This work speaks in favor of kynurenine being a new and valuable biomarker of CHF, with particular attention placed on its ability to predict mortality and reflect exercise capacity.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"39 1","pages":"765 - 776"},"PeriodicalIF":0.0000,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"16","resultStr":"{\"title\":\"Plasma Kynurenine Predicts Severity and Complications of Heart Failure and Associates with Established Biochemical and Clinical Markers of Disease\",\"authors\":\"T. Dschietzig, K. Kellner, K. Sasse, F. Boschann, R. Klüsener, J. Ruppert, F. Armbruster, D. Bankovic, A. Meinitzer, V. Mitrović, C. Melzer\",\"doi\":\"10.1159/000501483\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Kynurenine, a metabolite of the L-tryptophan pathway, plays a pivotal role in neuro-inflammation, cancer immunology, and cardiovascular inflammation, and has been shown to predict cardiovascular events. Objectives: It was our objective to increase the body of data regarding the value of kynurenine as a biomarker in chronic heart failure (CHF). Methods: We investigated the predictive value of plasma kynurenine in a CHF cohort (CHF, n = 114); in a second cohort of defibrillator carriers with CHF (AICD, n = 156), we determined clinical and biochemical determinants of the marker which was measured by enzyme immunoassay. Results: In the CHF cohort, both kynurenine and NT-proBNP increased with NYHA class. Univariate binary logistic regression showed kynurenine to predict death within a 6-month follow-up (OR 1.43, 95% CI 1.03–2.00, p = 0.033) whereas NT-proBNP did not contribute significantly. Kynurenine, like NT-proBNP, was able to discriminate at a 30% threshold of left ventricular ejection fraction (LVEF; AUC-ROC, both 0.74). Kynurenine correlated inversely with LVEF (ϱ = –0.394), glomerular filtration fraction (GFR; ϱ = –0.615), and peak VO2 (ϱ = –0.626). Moreover, there was a strong correlation of kynurenine with NT-proBNP (ϱ = 0.615). In the AICD cohort, multiple linear regression analysis demonstrated highly significant associations of kynurenine with GFR, hsCRP, and tryptophan, as well as a significant impact of age. Conclusions: This work speaks in favor of kynurenine being a new and valuable biomarker of CHF, with particular attention placed on its ability to predict mortality and reflect exercise capacity.\",\"PeriodicalId\":17810,\"journal\":{\"name\":\"Kidney and Blood Pressure Research\",\"volume\":\"39 1\",\"pages\":\"765 - 776\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"16\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney and Blood Pressure Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000501483\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney and Blood Pressure Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000501483","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 16
摘要
背景:犬尿氨酸是l -色氨酸途径的代谢物,在神经炎症、癌症免疫学和心血管炎症中起着关键作用,并已被证明可以预测心血管事件。目的:我们的目的是增加犬尿氨酸作为慢性心力衰竭(CHF)生物标志物价值的数据体。方法:研究血浆犬尿氨酸在CHF队列中的预测价值(CHF, n = 114);在第二组患有心力衰竭的除颤器携带者(AICD, n = 156)中,我们用酶免疫分析法测定了该标志物的临床和生化决定因素。结果:在CHF队列中,犬尿氨酸和NT-proBNP随NYHA分级而升高。单因素二元logistic回归显示,犬尿氨酸可预测6个月随访期间的死亡(OR 1.43, 95% CI 1.03-2.00, p = 0.033),而NT-proBNP无显著贡献。犬尿氨酸,像NT-proBNP一样,能够在30%的左心室射血分数(LVEF;AUC-ROC均为0.74)。犬尿氨酸与LVEF (ϱ = -0.394)、肾小球滤过分数(GFR;ϱ = -0.615),峰值VO2 (ϱ = -0.626)。此外,犬尿氨酸与NT-proBNP有很强的相关性(ϱ = 0.615)。在AICD队列中,多元线性回归分析显示犬尿氨酸与GFR、hsCRP和色氨酸高度显著相关,年龄也有显著影响。结论:这项工作支持犬尿氨酸作为一种新的有价值的CHF生物标志物,特别关注其预测死亡率和反映运动能力的能力。
Plasma Kynurenine Predicts Severity and Complications of Heart Failure and Associates with Established Biochemical and Clinical Markers of Disease
Background: Kynurenine, a metabolite of the L-tryptophan pathway, plays a pivotal role in neuro-inflammation, cancer immunology, and cardiovascular inflammation, and has been shown to predict cardiovascular events. Objectives: It was our objective to increase the body of data regarding the value of kynurenine as a biomarker in chronic heart failure (CHF). Methods: We investigated the predictive value of plasma kynurenine in a CHF cohort (CHF, n = 114); in a second cohort of defibrillator carriers with CHF (AICD, n = 156), we determined clinical and biochemical determinants of the marker which was measured by enzyme immunoassay. Results: In the CHF cohort, both kynurenine and NT-proBNP increased with NYHA class. Univariate binary logistic regression showed kynurenine to predict death within a 6-month follow-up (OR 1.43, 95% CI 1.03–2.00, p = 0.033) whereas NT-proBNP did not contribute significantly. Kynurenine, like NT-proBNP, was able to discriminate at a 30% threshold of left ventricular ejection fraction (LVEF; AUC-ROC, both 0.74). Kynurenine correlated inversely with LVEF (ϱ = –0.394), glomerular filtration fraction (GFR; ϱ = –0.615), and peak VO2 (ϱ = –0.626). Moreover, there was a strong correlation of kynurenine with NT-proBNP (ϱ = 0.615). In the AICD cohort, multiple linear regression analysis demonstrated highly significant associations of kynurenine with GFR, hsCRP, and tryptophan, as well as a significant impact of age. Conclusions: This work speaks in favor of kynurenine being a new and valuable biomarker of CHF, with particular attention placed on its ability to predict mortality and reflect exercise capacity.