HMGB1 is an independent predictor of death and heart transplantation in heart failure
HMGB1 is an independent predictor of death and heart transplantation in heart failure
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DOI：
10.1007/s00392-011-0409-x
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发表时间：
2012-06-01
影响因子：
5
通讯作者：
Andrassy, M.
中科院分区：
文献类型：
--
作者：
Volz, H. C.;Laohachewin, D.;Andrassy, M.
高迁移率族蛋白1（HMGB 1）是心肌炎症的重要介质，与心力衰竭（HF）的进展有关。本研究的目的是分析缺血性和非缺血性cardiomy.Methods和结果HF患者的全身HMGB 1水平的预后价值，我们进行了一项分析（中位随访时间2.5年）ofHMGB 1血浆浓度在154例收缩期HF和相关的结果与疾病的严重程度和预后。HMGB 1在重症心衰患者中的应用（NYHA III/IV级; 5.35 ng/ml;四分位距（IQR）= 3.48-8.42 ng/ml）与轻度症状患者相比显著升高（NYHA I/II; 3.37 ng/ml，IQR = 2.31-5.22 ng/ml，p < 0.0001）和对照组（3.25 ng/ml，IQR = 3.04-3.67 ng/ml，p < 0.0001）。HMGB 1水平与其他心力衰竭标志物相关，表明HMGB 1与HF疾病严重程度相关。在死亡和心脏移植联合终点的单变量考克斯回归模型中，基于HMGB 1三分位数3.4或6.1 ng/ml（分别为p = 0.001和p < 0.0001），HMGB 1被证明是临界值的预测因子。在多变量考克斯回归模型中，包括NT-proBNP、肌酐、年龄、NYHA分级、白色血细胞计数、贫血和年龄，HMGB 1仍然是联合终点的独立预测因子（风险比（HR）= 2.48，95%置信区间（CI）= 1.06-5.83，p = 0.037和HR = 2.48，95% CI = 1.31-4.71，p = 0.005，结论HMGB 1血浆浓度在心力衰竭患者中升高，并与疾病严重程度相关，是心力衰竭患者死亡和心脏移植联合终点的独立预测因子。
Background High-Mobility-Group Box 1 (HMGB1) has been established as an important mediator of myocardial inflammation and associated with progression of heart failure (HF). The aim of this study was to analyze the prognostic value of systemic HMGB1 levels in HF patients with ischemic and non-ischemic cardiomyopathy.Methods and results We conducted an analysis (median follow-up time 2.5 years) ofHMGB1 plasma concentration in 154 patients with systolic HF and correlated the results with disease severity and prognosis. HMGB1 in HF patients with severe symptoms (NYHA III/IV; 5.35 ng/ml; interquartile range (IQR) = 3.48-8.42 ng/ml) was significantly elevated compared with that in patients with mild symptoms (NYHA I/II; 3.37 ng/ml, IQR = 2.31-5.22 ng/ml, p < 0.0001) and with controls (3.25 ng/ml, IQR = 3.04-3.67 ng/ml, p < 0.0001). HMGB1 levels correlated with other markers of heart failure indicating an association ofHMGB1 with disease severity in HF. In a univariate cox regression model for the combined endpoint of death and heart transplantation, HMGB1 proved to be a predictor at cut-off values based on HMGB1 terciles of either 3.4 or 6.1 ng/ml (p = 0.001 and p < 0.0001, respectively). In a multivariate cox regression model, which included NT-proBNP, creatinine, age, NYHA class, white blood cell count, anemia, and age, HMGB1 remained an independent predictor of the combined endpoint (hazard ratio (HR) = 2.48, 95% confidence interval (CI) = 1.06-5.83, p = 0.037 and HR = 2.48, 95% CI = 1.31-4.71, p = 0.005, respectively).Conclusion Our findings demonstrate that HMGB1 plasma concentration is elevated in HF and correlates with disease severity and that is an independent predictor of the combined endpoint death and heart transplantation in HF patients.