Measurement of Novel Biomarkers to Predict Chronic Heart Failure Outcomes and Left Ventricular Remodeling
Measurement of Novel Biomarkers to Predict Chronic Heart Failure Outcomes and Left Ventricular Remodeling
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DOI：
10.1007/s12265-013-9522-8
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发表时间：
2014-03-01
影响因子：
3.4
通讯作者：
Januzzi, James L., Jr.
中科院分区：
文献类型：
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作者：
Motiwala, Shweta R.;Szymonifka, Jackie;Januzzi, James L., Jr.
心肌重构是慢性心力衰竭（HF）发生发展和并发症的关键。我们评估了142例HF患者的5种与重塑有生物学联系的生物标志物（双糖链蛋白聚糖、分泌型卷曲相关蛋白3、内皮抑素、胰岛素样生长因子结合蛋白7 [IGFBP 7]、mimecan）的连续测量，随访882次门诊访视。IGFBP 7和mimecan与事件最相关;在完全校正的模型中，各次访视中较低的IGFBP 7浓度独立预测较少的事件（比值比[OR] = 0.83; 95%置信区间[CI] = 0.73-0.95，p = 0.01）。mimecan升高的受试者左心室舒张末期（p = 0.07）和收缩末期（p = 0.01）容积下降幅度更大，射血分数增加幅度更大（p = 0.02），事件发生率最低。统计模型表明，几种HF药物可能导致IGFBP 7和mimecan值的变化。结果表明，IGFBP 7的连续测量提供了预后信息，而mimecan的变化可以提供关于心肌重塑的独特信息。
Myocardial remodeling is pivotal in the progression and complication of chronic heart failure (HF). We assessed serial measurement of five biomarkers with biologic links to remodeling (biglycan, secreted frizzled-related protein 3, endostatin, insulin-like growth factor binding protein 7 [IGFBP7], mimecan) in 142 patients with HF followed through 882 office visits. IGFBP7 and mimecan were most associated with events; in fully adjusted models, lower IGFBP7 concentrations across visits independently predicted fewer events (odds ratio [OR] = 0.83; 95 % confidence interval [CI] = 0.73-0.95, p = 0.01). Subjects with rising mimecan had greater decrease in left ventricular end diastolic (p = 0.07) and systolic (p = 0.01) volumes, greater increase in ejection fraction (p = 0.02), and had lowest event rates. Statistical models suggested several HF medications might lead to changes in both IGFBP7 and mimecan values. The results suggest serial measurement of IGFBP7 provides prognostic information, while changes in mimecan provide unique information regarding myocardial remodeling.