Role of Monokine Induced by Interferon Gamma in Discrimination and Prognosis of Patients With Chagas' Disease and Idiopathic Dilated Cardiomyopathy
Role of Monokine Induced by Interferon Gamma in Discrimination and Prognosis of Patients With Chagas' Disease and Idiopathic Dilated Cardiomyopathy
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DOI：
10.1097/fjc.0000000000000368
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发表时间：
2016-05-01
影响因子：
3
通讯作者：
Walther, Thomas
中科院分区：
文献类型：
--
作者：
Khan, Adnan;Wang, Yong;Walther, Thomas
目的：干扰素-γ诱导的趋化因子是一种趋化因子，可使感染克氏锥虫的小鼠心肌细胞内趋化因子增多。目前尚不清楚Chagas病(CD)和特发性扩张型心肌病(DCM)患者是否存在MIG调节。因此，我们的目的是探讨MIG在这些患者中可能的诊断和/或预后价值。方法和结果：在这项前瞻性队列研究中，检测了CD患者(n=93)和DCM患者(n=47)和健康对照组(n=24)的MIG。在慢性阻塞性肺疾病和晚期心力衰竭患者中，MIG显著升高(纽约心脏协会III，IV)。虽然扩张型心肌病患者的MIG水平没有明显升高，但在扩张型心肌病患者中，MIG水平与左心室射血分数显著相关。相比之下，尽管CD和晚期心力衰竭患者的数量显著增加，但MIG与CD的任何超声心动图参数均无显著相关性。MIG也未能预测CD患者的死亡率和心脏移植的必要性，但在DCM患者中显示出明显的趋势。结论：据我们所知，这是第一项关于CD和DCM患者MIG的研究。CD和晚期心力衰竭患者的MIG显著增加，MIG与左心室射血分数呈负相关，以及在DCM患者中发现的使用截断值进行区分的明显趋势，需要进一步的研究来阐明MIG在这些患者中的诊断和预后潜力。
Aims: Monokine induced by interferon gamma (MIG) is a chemokine that has been found to increase in the myocardium of mice infected with Trypanosoma cruzi. It is not known whether MIG is regulated in patients with Chagas' disease (CD) and idiopathic dilated cardiomyopathy (DCM). Therefore, we aimed to investigate the possible diagnostic and/or prognostic value of MIG in these patients.Methods and Results: In this prospective cohort study, MIG was measured in patients with CD (n = 93) and DCM (n = 47) and in healthy control subjects (n = 24). MIG was found to be significantly increased in patients with CD and advanced heart failure (New York Heart Association III IV). Although no significant increase in MIG levels was observed in patients with DCM, there was a significant correlation between MIG and left ventricular ejection fraction in patients with DCM. In contrast, despite the significant increase in patients with CD and advanced heart failure, MIG had no significant correlation with any of the echocardiographic parameters in CD. MIG also failed to predict mortality and necessity for heart transplant in patients with CD but showed a clear trend for patients with DCM.Conclusions: To the best of our knowledge, this is the first study to investigate MIG in patients with CD and DCM. The significant increase of MIG in patients with CD and advanced heart failure, the negative correlation between MIG and left ventricular ejection fraction, and the clear trend in discrimination using a cutoff value found in patients with DCM require further investigation to clarify the diagnostic and prognostic potential of MIG in these patients.