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DOI：
10.1097/01.ccm.0000551010.89859.a1
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发表时间：
2019-01
影响因子：
8.8
通讯作者：
Karan B. Karki;J. Towbin;R. Philip;Samir S Shah;S. Tadphale;Arun Saini
中科院分区：
文献类型：
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作者：
Karan B. Karki;J. Towbin;R. Philip;Samir S Shah;S. Tadphale;Arun Saini
方法：对 1 个月至 18 岁的心力衰竭儿童与年龄和性别匹配的健康儿童对照组进行前瞻性病例对照研究。结果：共有 54 名心力衰竭儿童（66% 为男性）和 38 名健康对照者入组。研究组的中位年龄 (IQR) 为 13.1 (2.5–17.2) 岁。心力衰竭的病因为左心室致密化不全心肌病 24 例（44%）、扩张型心肌病 11 例（20%）、肥厚型心肌病 4 例（7%）、限制性心肌病 2 例（4%）、急性心肌炎 3 例（6%）、混合性心肌病 3 例（6%）和先天性心脏病 7 例（13%）。根据 NYHA/Ross 心力衰竭分级，儿童分布为 I 级 23 名（42%）、II 级 16 名（30%）、III 级 4 名（8%）和 IV 级 11 名（20%）儿童。与对照组的 6.2 pg/ml (5.8-6.8) 相比，研究组的中位 (IQR) 和肽素水平升高了 47 pg/ml (13-317) (p < 0.001)。和肽素与 BNP 水平具有很强的相关性（ρ= 0.96，p < 0.001），与心力衰竭分级具有中等相关性（ρ= 0.56，p < 0.001）。和肽素水平与左心房容积呈中度相关（ρ= 0.62，p < 0.001），与左心室射血分数呈弱负相关（ρ=-0.23，p= 0.134）。结论：这是第一项报告心衰儿童和肽素水平的研究。心力衰竭儿童和肽素水平升高。和肽素水平与 BNP 水平有很强的相关性，与心力衰竭的严重程度和超声心动图变量有中度相关性。需要进行更大规模的多中心研究来评估和肽素作为心力衰竭儿童的预后和治疗标志物的作用。
Methods: A prospective case-control study of children ages 1 month to 18 years with HF compared with age-and sex-matched control group of healthy children.Results: A total of 54 children (66% males) with HF and 38 healthy controls were enrolled. The median (IQR) age of the study group was 13.1 (2.5–17.2) years. The etiology of the HF was left ventricular non-compaction cardiomyopathy in 24 (44%), dilated cardiomyopathy in 11 (20%), hypertrophic cardiomyopathy in 4 (7%), restrictive cardiomyopathy in 2 (4%), acute myocarditis in 3 (6%), mixed cardiomyopathy in 3 (6%) and congenital heart disease in 7 (13%). The distribution of children based on NYHA/Ross heart failure grading was Class I in 23 (42%), Class II in 16 (30%), Class III in 4 (8%) and class IV in 11 (20%) children. The median (IQR) copeptin level in the study group was elevated 47pg/ml (13–317) compared to the control group 6.2 pg/ml (5.8–6.8)(p< 0.001). The copeptin had strong correlation with BNP level (ρ= 0.96, p< 0.001) and moderate correlation with heart failure grading (ρ= 0.56, p< 0.001). The copeptin level had moderate correlation with left atrial volume (ρ= 0.62, p< 0.001) and weak negative correlation with left ventricular ejection fraction (ρ=-0.23, p= 0.134).Conclusions: This is the first study to report copeptin levels in children with HF. Copeptin level is elevated in children with HF. Copeptin level has a strong correlation with the BNP level and moderate correlation with the severity of HF and echocardiographic variables. A larger multi-center study is needed to assess the role of copeptin as a prognostic and therapeutic marker in children with HF.