Prognostic value of endothelial microparticles in patients with heart failure
Prognostic value of endothelial microparticles in patients with heart failure
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DOI：
10.1093/eurjhf/hfq145
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发表时间：
2010-11-01
影响因子：
18.2
通讯作者：
Ogawa, Hisao
中科院分区：
文献类型：
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作者：
Nozaki, Toshimitsu;Sugiyama, Seigo;Ogawa, Hisao
心力衰竭（HF）与内皮功能障碍有关。内皮衍生微粒（EMPs）是一种新的定量血浆内皮功能障碍的标志物。我们研究了血浆EMP水平是否可以预测HF患者未来的心血管事件。我们连续招募了169例纽约心脏协会（NYHA）I级或以上的HF患者（70例缺血性HF，99例非缺血性HF）。采用流式细胞术检测HF患者和31名健康受试者的血浆CD 144阳性EMP水平。我们对HF患者进行了平均30个月的随访。终点为：心血管事件（心肌梗死、卒中、因HF再次住院和心血管死亡）和全因死亡的复合终点。内皮源性微粒水平随NYHA心功能分级显著增加[EMP中位数（范围）：健康，0.325（0.164-0.354）x10（6）/mL; NYHA I，0.484（0.426-0.575）; II，0.646（0.439-0.795）;和III/IV，0.786（0.569-1.026），P < 0.001]。共登记了33例心血管事件和22例全因死亡。Kaplan-Meier分析表明，高EMP组心血管事件的概率显著更高，但全因死亡率仅存在临界差异（高于中位数;对数秩检验分别为P = 0.01，P = 0.053）。校正临床因素后的多变量考克斯回归分析显示，高EMP水平是HF患者未来心血管事件的独立预测因子，但不是全因死亡率的独立预测因子[风险比（95%置信区间）：2.423（1.034-5.681），心血管事件P = 0.04; 2.095（0.825-5.323），全因死亡率P = 0.12]通过血浆EMP水平评估内皮功能障碍可以独立预测HF患者未来的心血管事件。内皮源性微粒是HF危险分层中内皮功能障碍的潜在有用的生物标志物。
Heart failure (HF) is associated with endothelial dysfunction. Endothelium-derived microparticles (EMPs) are a novel quantitative plasma marker of endothelial dysfunction. We investigated whether plasma levels of EMPs can predict future cardiovascular events in patients with HF.We enrolled 169 consecutive HF patients (70 ischaemic, 99 non-ischaemic HF) with New York Heart Association (NYHA) class I or more. Plasma CD144-positive EMP levels were measured by flow cytometry in the HF patients and in 31 healthy subjects. We followed the HF patients for mean 30 months. Endpoints were: a composite of cardiovascular events (myocardial infarction, stroke, re-hospitalization for HF, and cardiovascular death) and all-cause mortality. Endothelium-derived microparticle levels increased significantly with NYHA functional class [EMP median (range): healthy, 0.325 (0.164-0.354) x10(6)/mL; NYHA I, 0.484 (0.426-0.575); II, 0.646 (0.439-0.795); and III/IV, 0.786 (0.569-1.026), P < 0.001]. A total of 33 cardiovascular events and 22 all-cause deaths were registered. Kaplan-Meier analysis demonstrated a significantly higher probability of cardiovascular events in the high-EMP group, but there was only a borderline difference for all-cause mortality (above median; log rank test P = 0.01, P = 0.053, respectively). Multivariate Cox regression analysis adjusted for clinical factors, identified high-EMP levels as an independent predictor of future cardiovascular events, but not for all-cause mortality in HF patients [hazard ratio (95% confidence interval): 2.423 (1.034-5.681), P = 0.04 for cardiovascular events; and 2.095 (0.825-5.323), P = 0.12 for all-cause mortality].Endothelial dysfunction assessed by plasma levels of EMPs can independently predict future cardiovascular events in patients with HF. Endothelium-derived microparticles are a potentially useful biomarker of endothelial dysfunction in HF risk stratification.