Circulating Fibroblast Growth Factor 21 is Associated with Diastolic Dysfunction in Heart Failure Patients with Preserved Ejection Fraction.
Circulating Fibroblast Growth Factor 21 is Associated with Diastolic Dysfunction in Heart Failure Patients with Preserved Ejection Fraction.
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DOI：
10.1038/srep33953
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发表时间：
2016-09-21
影响因子：
4.6
通讯作者：
Lin SJ
中科院分区：
文献类型：
--
作者：
Chou RH;Huang PH;Hsu CY;Chang CC;Leu HB;Huang CC;Chen JW;Lin SJ
成纤维细胞生长因子21（Fibroblast growth factor 21，FGF 21）是一种促进糖代谢和脂质代谢的多肽配体，近年来被报道具有减轻心肌肥厚的作用。本研究的目的是研究FGF 21在舒张性心力衰竭中的作用。接受冠状动脉造影的受试者接受心力衰竭筛查，排除左心室（LV）射血分数< 45%的受试者。舒张功能障碍定义为超声心动图标准的左室舒张和充盈期间存在的功能异常。测定血浆FGF 21和N-末端脑钠肽前体（NT-pro-BNP）水平。所有患者随访1年，或直至发生心力衰竭再入院或死亡。入选舒张功能不全患者95例，对照组143例。循环FGF 21水平与超声心动图舒张功能参数和左室舒张末期压（LVEDP）相关。在多变量logistic分析中，FGF 21与舒张功能障碍显著相关，通过超声心动图标准鉴定（比值比：2.97，p = 0.012）或通过LVEDP水平证实（比值比：3.73，p = 0.030）。血浆FGF 21（log rank p < 0.0001）和NT-pro-BNP水平（log rank p = 0.0057）均显示出对1年不良心脏事件的良好预测能力。这一发现表明FGF 21可能参与舒张性心力衰竭的病理生理学。
Fibroblast growth factor 21 (FGF21), a polypeptide ligand promoted glucose homeostasis and lipids metabolism, was recently reported to attenuate cardiac hypertrophy. The aim of this study was to investigate the impact of FGF21 in diastolic heart failure. Subjects admitted for coronary angiogram were screened for heart failure, and those with left ventricular (LV) ejection fraction < 45% were excluded. Diastolic dysfunction was defined as functional abnormalities that exist during LV relaxation and filling by echocardiographic criteria. Plasma levels of FGF21 and N-terminal Pro-Brain Natriuretic Peptide (NT-pro-BNP) were determined. All patients were followed up for 1 year, or till the occurrence of heart failure readmission or death. Totally 95 patients with diastolic dysfunction and 143 controls were enrolled. Circulating FGF21 level was correlated with echocardiographic parameters of diastolic function and LV end-diastolic pressure (LVEDP). In multivariate logistic analysis, FGF21 was significantly associated with diastolic dysfunction, either identified by echocardiographic criteria (odds ratio: 2.97, p = 0.012) or confirmed with LVEDP level (odds ratio: 3.73, p = 0.030). Both plasma FGF21 (log rank p < 0.0001) and NT-pro-BNP levels (log rank p = 0.0057) showed good predictive power to the 1-year adverse cardiac events. This finding suggested FGF21 could be involved in the pathophysiology of diastolic heart failure.
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