C Pujol, N Varo Cenarruzabeitia, M Rodríguez Mañero, J Barba, S Castaño Rodríguez, A Macías Gallego, M J Torres, I García Bolao
{"title":"sCD40L在预测心脏再同步化治疗超反应中的作用。","authors":"C Pujol, N Varo Cenarruzabeitia, M Rodríguez Mañero, J Barba, S Castaño Rodríguez, A Macías Gallego, M J Torres, I García Bolao","doi":"10.23938/ASSN.0947","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.</p><p><strong>Methods: </strong>Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.</p><p><strong>Results: </strong>50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?<?0.0001) and lateral (0 vs. 18%, p?=?0.03), inferior (4 vs. 33%, p?=?0.01) and posterior infarction (0 vs. 22%, p?=?0.01); absence of mitral regurgitation (47% vs. 22%, p?=?0.04), wider QRS width (157.7?±?22.9 vs. 140.8?±?19.2ms, p?=?0.01), higher concentrations of sCD40L (6.9?±?5.1 vs. 4.4?±?3.3 ng/mL, p?=?0.02), and left ventricular lead more frequent in lateral medial position (69 vs. 26%, p?=?0.002). QRS width, lateral medial position of the lead and absence of mitral regurgitation were independent predictors of SR. sCD40L showed a moderate direct correla-tion with SR (r?=?0.39, p?=?0.02) and with the reduction of LVESV (r?=?0.44, p?=?0.02).</p><p><strong>Conclusions: </strong>sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.</p>","PeriodicalId":7775,"journal":{"name":"Anales Del Sistema Sanitario De Navarra","volume":"44 2","pages":"205-214"},"PeriodicalIF":1.0000,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/e0/assn-44-02-205.PMC10019534.pdf","citationCount":"0","resultStr":"{\"title\":\"Role of sCD40L in the prediction of super-response to cardiac resynchronization therapy.\",\"authors\":\"C Pujol, N Varo Cenarruzabeitia, M Rodríguez Mañero, J Barba, S Castaño Rodríguez, A Macías Gallego, M J Torres, I García Bolao\",\"doi\":\"10.23938/ASSN.0947\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.</p><p><strong>Methods: </strong>Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.</p><p><strong>Results: </strong>50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?<?0.0001) and lateral (0 vs. 18%, p?=?0.03), inferior (4 vs. 33%, p?=?0.01) and posterior infarction (0 vs. 22%, p?=?0.01); absence of mitral regurgitation (47% vs. 22%, p?=?0.04), wider QRS width (157.7?±?22.9 vs. 140.8?±?19.2ms, p?=?0.01), higher concentrations of sCD40L (6.9?±?5.1 vs. 4.4?±?3.3 ng/mL, p?=?0.02), and left ventricular lead more frequent in lateral medial position (69 vs. 26%, p?=?0.002). QRS width, lateral medial position of the lead and absence of mitral regurgitation were independent predictors of SR. sCD40L showed a moderate direct correla-tion with SR (r?=?0.39, p?=?0.02) and with the reduction of LVESV (r?=?0.44, p?=?0.02).</p><p><strong>Conclusions: </strong>sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.</p>\",\"PeriodicalId\":7775,\"journal\":{\"name\":\"Anales Del Sistema Sanitario De Navarra\",\"volume\":\"44 2\",\"pages\":\"205-214\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2021-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/e0/assn-44-02-205.PMC10019534.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anales Del Sistema Sanitario De Navarra\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23938/ASSN.0947\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales Del Sistema Sanitario De Navarra","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23938/ASSN.0947","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
背景:本文的目的是分析生物标志物白介素6、肿瘤坏死因子a、sCD40L、高敏肌钙蛋白T、高敏c反应蛋白和半乳糖凝集素-3在预测心脏再同步化治疗(CRT)超反应(SR)中的作用，因为这些标志物在该领域尚未被研究。方法:术前和术后1年的临床、心电图和超声心动图资料。SR定义为1年随访时LVESV降低= 30%。植入前提取血液样本。进行多因素logistic回归和ROC曲线分析。结果:纳入50例患者，23例(46%)为SR。SR相关特征为:女性(35例vs. 11%， p = 0.04)，缺血性心肌病较少(13例vs. 63%， p = 0.04)。结论:sCD40L与SR与CRT有显著相关性。QRS宽度、二尖瓣不反流和导联外侧内侧位置是该队列中SR的独立预测因素。
Role of sCD40L in the prediction of super-response to cardiac resynchronization therapy.
Background: The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.
Methods: Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.
Results: 50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?
Conclusions: sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.
期刊介绍：
La revista Anales del Sistema Sanitario de Navarra es una revista de contenido médico sanitario de carácter generalista. En ella tienen cabida artículos referidos a temas de salud/enfermedad en general, salud pública, administración y gestión sanitaria y Atención Primaria de salud.
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