Prognostic value of serum parathyroid hormone level in acute decompensated heart failure.
Prognostic value of serum parathyroid hormone level in acute decompensated heart failure.
复制标题
血清甲状旁腺激素水平在急性失代偿性心力衰竭中的预后价值。
作者：
T. Sugimoto;K. Dohi;K. Onishi;Tomomi Yamada;M. Horiguchi;T. Takamura;A. Kawamura;T. Seko;Mashio Nakamura;A. Kasai;Masaaki Ito
背景
继发性甲状旁腺功能亢进是对慢性心力衰竭（HF）和肾衰竭的代偿反应。甲状旁腺激素（PTH）水平在急性失代偿性心力衰竭中的作用尚不清楚。因此，本研究的目的是探讨急性失代偿性心力衰竭患者的死亡率、肾功能和血清PTH水平之间的关系。方法和结果： 共入组了266例因急性失代偿性HF而住院的连续患者（78 ± 12岁; 48%为男性），无急性冠状动脉综合征。 在入院时获得人口统计学、临床和实验室特征。在1年的随访中，65例患者（24%）死亡。108例（41%）患者入院时血清PTH水平在正常范围（10 - 65 pg/ml）内，其中39例（15%）患者PTH水平低于正常值（10 - 40 pg/ml）。Kaplan-Meier分析显示，PTH正常值偏低患者的全因死亡率显著高于PTH正常值偏高（40 - 65 pg/ml）或PTH正常值偏高（> 65 pg/ml）患者（对数秩检验）。在单变量和多变量考克斯回归分析中，低正常PTH与全因死亡率增加显著相关（未校正HR，2.88; 95% CI：1.69 - 4.91; P <0.001;校正HR，3.84; 95% CI：1.54 - 9.57; P = 0.004）。
结论
在急性失代偿性HF导致住院的患者中，入院时PTH正常偏低与全因死亡率增加相关，与肾功能无关。
BACKGROUND
Secondary hyperparathyroidism develops as a compensatory response to chronic heart failure (HF) and renal failure. The role of parathyroid hormone (PTH) level in acute decompensated HF remains unclear. The aim of this study was therefore to investigate the relationships among mortality, renal function, and serum PTH level in acute decompensated HF patients. METHODS AND RESULTS: A total of 266 consecutive patients admitted for acute decompensated HF without acute coronary syndrome (78±12 years; 48% male) were enrolled. Demographic, clinical, and laboratory characteristics were obtained on admission.During 1-year follow-up, 65 patients (24%) died. Serum PTH level on admission was within the normal range (10-65 pg/ml) in 108 patients (41%), of whom 39 (15%) had low-normal PTH (10-40 pg/ml). On Kaplan-Meier analysis all-cause mortality was significantly higher in patients with low-normal PTH than in those with high-normal (40-65 pg/ml) or high (>65 pg/ml) PTH (log-rank test). On univariate and multivariate Cox regression analysis, low-normal PTH was significantly associated with increased all-cause mortality (unadjusted HR, 2.88; 95% CI: 1.69-4.91; P<0.001; adjusted HR, 3.84; 95% CI: 1.54-9.57; P=0.004).
CONCLUSIONS
In patients with acute decompensated HF resulting in hospitalization, low-normal PTH on admission is associated with increased all-cause mortality, regardless of renal function.
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DOI：
10.1681/asn.2010020186
发表时间：
2011-03
期刊：
Journal of the American Society of Nephrology : JASN
影响因子：
--
作者：
Kumar R;Thompson JR
通讯作者：
Thompson JR
甲状旁腺激素和甲状旁腺激素相关肽的正变时作用与电流、I(f) 和起搏器电位斜率的增加有关。
影响因子：
37.8
作者：
Hara,M;Liu,YM;Zhen,L;Cohen,IS;Yu,H;DaniloJr,P;Ogino,K;Bilezikian,JP;Rosen,MR
通讯作者：
Rosen,MR
影响因子：
120.7
作者：
Isakova, Tamara;Xie, Huiliang;Yang, Wei;Xie, Dawei;Anderson, Amanda Hyre;Scialla, Julia;Wahl, Patricia;Gutierrez, Orlando M.;Steigerwalt, Susan;He, Jiang;Schwartz, Stanley;Lo, Joan;Ojo, Akinlolu;Sondheimer, James;Hsu, Chi-yuan;Lash, James;Leonard, Mary;Kusek, John W.;Feldman, Harold I.;Wolf, Myles
通讯作者：
Wolf, Myles
甲状旁腺激素（PTH）和 PTH 相关蛋白对心脏影响的血流动力学基础。
DOI：
10.1210/endo.136.7.7789328
发表时间：
1995
期刊：
Endocrinology.
影响因子：
--
作者：
Ogino,K;Burkhoff,D;Bilezikian,JP
通讯作者：
Bilezikian,JP
影响因子：
15.9
作者：
Ben-Dov, Iddo Z.;Galitzer, Hillel;Silver, Justin
通讯作者：
Silver, Justin