Decreased level of melatonin in serum predicts left ventricular remodelling after acute myocardial infarction
Decreased level of melatonin in serum predicts left ventricular remodelling after acute myocardial infarction
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DOI：
10.1111/j.1600-079x.2012.01001.x
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发表时间：
2012-10-01
影响因子：
10.3
通讯作者：
Reiter, Russel J.
中科院分区：
文献类型：
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作者：
Dominguez-Rodriguez, Alberto;Abreu-Gonzalez, Pedro;Reiter, Russel J.
由于实验研究表明，褪黑激素是心肌梗死（MI）后的心脏保护，本研究旨在探讨循环褪黑激素水平和左心室（LV）重构急性MI后的患者之间的关系。这项前瞻性研究纳入了161例接受直接经皮冠状动脉介入治疗的患者（年龄61 ± 3岁; 78%为男性），这些患者在出院（第37天）和12个月时接受了超声心动图评估。LV重构定义为12个月随访时LV舒张末期容积较基线增加>20%。血清褪黑激素浓度测定入院时，在光周期。24例患者显示LV重构，137例无LV重构证据。左室重构患者在研究开始时褪黑激素水平较低[分别为9.96（8.28 ± 11.03）vs 16.74（13.77 ± 19.59）pg/mL; P < 0.0001]。多因素分析显示褪黑素水平（OR = 2.10，95% CI 1.5472.870，P < 0.001）是12个月随访时左室重构的独立预测因子。受试者工作特征（ROC）分析显示曲线下面积为0.959（CI 95% 0.93 - 0.98; P < 0.0001）。据我们所知，这是第一个研究表明褪黑激素和左室重构之间的关系，在慢性期后心肌梗死。
As experimental studies suggest that melatonin is cardioprotective after myocardial infarction (MI), this study sought to investigate the relationships between circulating levels of melatonin and left ventricular (LV) remodelling in patients after acute MI. This prospective study included 161 patients (age 61 +/- 3 yr; 78% men) undergoing primary percutaneous coronary intervention who were assessed echocardiographically at hospital discharge (day 37) and at 12 months. LV remodelling was defined as >20% increase in LV end-diastolic volume at 12-month follow-up compared with baseline. Serum melatonin concentrations were measured at admission, during the light period. Twenty-four patients showed LV remodelling, and 137 had no evidence of LV remodelling. Patients with LV remodelling had lower levels of melatonin at study entry [9.96 (8.2811.03) versus 16.74 (13.7719.59) pg/mL, respectively; P < 0.0001]. Multivariate analysis showed that melatonin levels (OR = 2.10, CI 95% 1.5472.870, P < 0.001) were an independent predictor of LV remodelling at 12-month follow-up. Receiver operating characteristic (ROC) analysis showed an area under the curve of 0.959 (CI 95% 0.930.98; P < 0.0001). To our knowledge, this is the first study to show the relationship between melatonin and LV remodelling during the chronic phase post-MI.