Enhanced oxidative stress and presence of ventricular aneurysm for risk prediction in cardiac sarcoidosis.
Enhanced oxidative stress and presence of ventricular aneurysm for risk prediction in cardiac sarcoidosis.
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DOI：
10.1136/heartjnl-2021-320244
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Yano M
中科院分区：
文献类型：
--
作者：
Yoshitomi R;Kobayashi S;Yano Y;Nakashima Y;Fujii S;Nanno T;Ishiguchi H;Fukuda M;Yoshiga Y;Okamura T;Suga K;Kawano R;Yano M
心脏性猝死(SCD)是心脏结节病(CS)的主要死亡原因。我们的目标是确定CS患者持续性室性心动过速(SVT)和SCD的预后标志。我们在2008年6月至2020年3月期间对根据日本或心脏节律学会指南诊断为CS的患者进行了前瞻性观察队列研究。主要终点是第一个SVT和SCD的复合体。入院时测定尿8-羟基-2‘-脱氧鸟苷(U-8-OHdG)、反映CS炎症活动性的DNA氧化损伤标志物以及心功能和肾功能指数。共纳入89例CS患者，排除心脏18F-脱氧葡萄糖(18F-FDG)无异常积聚28例和18F-FDG异常积聚61例，平均随访时间46个月(IQR：20~84)。随访期间，61例患者中有15例出现室上性心动过速(n=12)或SCD(n=3)。Cox比例风险模型显示U-8-OHdG浓度和室壁瘤(VA)是首次SVT/SCD的独立预测因素。U-8-OHdG预测首次SVT/SCD的临界值为14.9 ng/mg·cr。U-8-OHdG、≥、VA14.9 ng/mg.cr和VA的患者发生室上性心动过速/系统性红斑狼疮的风险显著增加。U-8-OHdG和VA的存在是CS患者首次SVT/SCD的有力预测因子，有助于心脏事件的分层，并提供有关室性心动过速的相关信息。
Sudden cardiac death (SCD) is the major cause of death in cardiac sarcoidosis (CS). We aimed to identify the prognostic markers for sustained ventricular tachycardia (sVT) and SCD in patients with CS. We performed a prospective observational cohort study for patients with CS diagnosed according to the Japanese or Heart Rhythm Society guidelines between June 2008 and March 2020 in our hospital. The primary endpoint was a composite of the first sVT and SCD. The levels of urinary 8-hydroxy-2′-deoxyguanosine (U-8-OHdG), a marker of oxidative DNA damage that reflects the inflammatory activity of CS, other biomarkers, and indices of cardiac function and renal function were measured on admission. Eighty-nine consecutive patients with CS were enrolled; 28 patients with no abnormal 18F-fluorodeoxyglucose (18F-FDG) accumulation in the heart were excluded and 61 patients with abnormal 18F-FDG accumulation were followed up for a median of 46 months (IQR: 20–84). During the follow-up period, 15 of 61 patients showed sVT (n=12) or SCD (n=3). A Cox proportional hazard model showed that U-8-OHdG concentration and presence of ventricular aneurysm (VA) were independent predictors of first sVT/SCD. The cut-off U-8-OHdG concentration for predicting first sVT/SCD was 14.9 ng/mg·Cr. Patients with U-8-OHdG concentration ≥14.9 ng/mg·Cr and VA showed a significantly increased risk of sVT/SCD. U-8-OHdG and presence of VA were powerful predictors of first sVT/SCD in patients with CS, facilitating the stratification of cardiac events and providing relevant information about the substrates of ventricular tachycardia.
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影响因子：
37.8
作者：
Yano, M;Okuda, S;Matsuzaki, M
通讯作者：
Matsuzaki, M
DOI：
10.1016/j.hroo.2021.07.005
发表时间：
2021-08
期刊：
Heart rhythm O2
影响因子：
--
作者：
Viwe M;Nery P;Birnie DH
通讯作者：
Birnie DH
影响因子：
39.3
作者：
Ekstrom, Kaj;Lehtonen, Jukka;Kupari, Markku
通讯作者：
Kupari, Markku
影响因子：
6.1
作者：
Priori, Silvia G.;Blomstrom-Lundqvist, Carina;Van Veldhuisen, Dirk J.
通讯作者：
Van Veldhuisen, Dirk J.
影响因子：
37.8
作者：
Patel MR;Cawley PJ;Heitner JF;Klem I;Parker MA;Jaroudi WA;Meine TJ;White JB;Elliott MD;Kim HW;Judd RM;Kim RJ
通讯作者：
Kim RJ