Significance of myocardial tenascin-C expression in left ventricular remodelling and long-term outcome in patients with dilated cardiomyopathy.
Significance of myocardial tenascin-C expression in left ventricular remodelling and long-term outcome in patients with dilated cardiomyopathy.
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DOI：
10.1002/ejhf.464
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发表时间：
2016-04
影响因子：
18.2
通讯作者：
Anzai, Toshihisa
中科院分区：
文献类型：
--
作者：
Yokokawa, Tetsuro;Sugano, Yasuo;Nakayama, Takafumi;Nagai, Toshiyuki;Matsuyama, Taka-aki;Ohta-Ogo, Keiko;Ikeda, Yoshihiko;Ishibashi-Ueda, Hatsue;Nakatani, Takeshi;Yasuda, Satoshi;Takeishi, Yasuchika;Ogawa, Hisao;Anzai, Toshihisa
扩张型心肌病(DCM)的病因多种多样，目前尚无有效的方法预测左心室(LV)重构和远期预后。心肌肌钙蛋白-C(TNC)是已知在病理条件下出现的，可能调节心脏重构。本研究的目的是阐明心肌TNC表达在左室重构和扩张型心肌病的长期预后中的意义。对123例连续接受心内膜心肌活检初步诊断的扩张型心肌病患者进行了研究。用免疫组织化学方法分析心肌活检切片中TNC的表达，以量化TNC阳性面积与整个心肌组织面积的比值。对与TNC区域相关的临床参数进行调查。根据TNC区的受试者操作特征分析将患者分为两组：高TNC组和低TNC组，TNC区≥分别为2.3%和2.3%。高TNC与糖尿病相关。比较心内膜心肌活检前和术后9个月的超声心动图表现，低TnC组与左室舒张末期内径减小和左心室射血分数增加有关，而高TnC组与之无关。(2)低 组与心内膜心肌活检后9个月超声心动图结果比较，低TnC组与LV舒张末内径减小、LV射血分数增加有关。生存分析显示，高TNC组的预后比低TNC组差(P <； 0.001)。多因素COX回归分析显示，中性粒细胞面积与不良预后独立相关(HR = 1.347，P = 0.032)。心肌TNC表达增加与DCM患者较差的左室重构和远期预后相关。
Dilated cardiomyopathy (DCM) has a variety of causes, and no useful approach to predict left ventricular (LV) remodelling and long‐term outcome has yet been established. Myocardial tenascin‐C (TNC) is known to appear under pathological conditions, possibly to regulate cardiac remodelling. The aim of this study was to clarify the significance of myocardial TNC expression in LV remodelling and the long‐term outcome in DCM. One hundred and twenty‐three consecutive DCM patients who underwent endomyocardial biopsy for initial diagnosis were studied. Expression of TNC in biopsy sections was analysed immunohistochemically to quantify the ratio of the TNC‐positive area to the whole myocardial tissue area (TNC area). Clinical parameters associated with TNC area were investigated. The patients were divided into two groups based on receiver operating characteristic analysis of TNC area to predict death: high TNC group with TNC area ≥2.3% (22 patients) and low TNC group with TNC area <2.3% (101 patients). High TNC was associated with diabetes mellitus. Comparing echocardiographic findings between before and 9 months after endomyocardial biopsy, the low TNC group was associated with decreased LV end‐diastolic diameter and increased LV ejection fraction, whereas the high TNC group was not. Survival analysis revealed a worse outcome in the high TNC group than in the low TNC group (P < 0.001). Multivariable Cox regression analysis revealed that TNC area was independently associated with poor outcome (HR = 1.347, P = 0.032). Increased myocardial TNC expression was associated with worse LV remodeling and long‐term outcome in DCM.
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影响因子：
2.9
作者：
Imanaka-Yoshida, K;Matsumoto, K;Yoshida, T
通讯作者：
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39.3
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