Serum Pregnancy-Associated Plasma Protein A in Patients With Heart Failure
Serum Pregnancy-Associated Plasma Protein A in Patients With Heart Failure
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DOI：
10.1016/j.cardfail.2011.05.011
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发表时间：
2011-10-01
影响因子：
6
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Funayama, Akira;Shishido, Tetsuro;Kubota, Isao
背景资料：妊娠相关血浆蛋白A（PAPP-A）蛋白水解胰岛素样生长因子（IGF）结合蛋白，从而增加IGF-1的生物活性。据报道，PAPP-A与各种病理生理异常有关;然而，尚未研究PAPP-A在心力衰竭（HF）病例中的临床意义。我们假设，PAPP-A水平可能与HF的严重程度。方法和结果：PAPP-A和B型利钠肽（BNP）水平测定262例（182 IT患者和80名对照组）。HF患者的PAPP-A水平高于对照组，并随纽约心脏协会心功能分级的提高而升高。在平均796天的随访期内发生了53起心脏事件。发生心脏事件的患者PAPP-A水平高于无心脏事件的患者。根据PAPP-A和BNP水平将患者分为3组。结论：血浆PAPP-A水平与心力衰竭的严重程度相关，与心力衰竭患者发生不良心脏事件的风险相关，提示PAPP-A可能参与心力衰竭的发病过程。（J Cardiac Fail 2011;17：819-826）
Background: Pregnancy-associated plasma protein A (PAPP-A) proteolyzes insulin-like growth factor (IGF)-binding proteins and thus increases IGF-1 bioactivity. PAPP-A has been reported to be involved in various pathophysiologic abnormalities; however, the clinical significance of PAPP-A has not been examined in cases of heart failure (HF). We hypothesized that PAPP-A levels might be correlated with the severity of HF.Methods and Results: PAPP-A and B-type natriuretic peptide (BNP) levels were measured in 262 subjects (182 IT patients and 80 control subjects). PAPP-A levels were higher in patients with HF than in control subjects and increased with advancing New York Heart Association functional class. There were 53 cardiac events during a mean follow-up period of 796 days. PAPP-A levels were higher in patients with cardiac events than in event-free patients. Patients were divided into 3 groups on the basis of their PAPP-A and BNP levels. Kaplan-Meier analysis demonstrated that the group with both high BNP with high PAPP-A had a significantly higher cardiac event rate than other groups.Conclusions: Serum PAPP-A levels were related to the severity of HF and associated with a high risk for adverse cardiac events in HF patients, suggesting that PAPP-A might be involved in the pathogenesis of HF. (J Cardiac Fail 2011;17:819-826)