Transforming growth factor beta 1 (TGF-beta 1) in atrial fibrillation and acute congestive heart failure
Transforming growth factor beta 1 (TGF-beta 1) in atrial fibrillation and acute congestive heart failure
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DOI：
10.1007/s00392-010-0248-1
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发表时间：
2011-04-01
影响因子：
5
通讯作者：
Brueckmann, Martina
中科院分区：
文献类型：
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作者：
Behnes, Michael;Hoffmann, Ursula;Brueckmann, Martina
心房颤动(AF)和急性充血性心力衰竭(ACHF)的特征是心脏重构不良。间质纤维化可导致心律失常或结构性重构。转化生长因子β1(TGF-β1)是心肌纤维化的中枢调节因子。本研究调查了房颤和房颤患者的血清转化生长因子-β1水平。401名出现呼吸困难或周围水肿症状的患者被纳入本研究。用于检测转化生长因子-β1的血液样本(R&D系统公司)和氨基末端脑利钠肽原(NT-proBNP)(DadeBehring Ltd.)有房颤患者的中位转化生长因子-β1水平(21.0 ng/ml，四分位数范围(IR15.4-27.6 ng/ml，n=107)低于非房颤患者(25.0 ng/ml，IR18.5-31.6 ng/ml，n=294)(P=0.009)。急性充血性心力衰竭患者血清转化生长因子-β1水平(中位数22.0 ng/ml，IR15.6~27.1 ng/ml，n=122)低于非心衰组(中位数24.9 ng/ml，IR18.1~31.9 ng/ml，n=0.0005)。在Logistic回归模型中，转化生长因子-β1仍与房颤[优势比(OR)3.00，95%可信区间1.37~6.61，p=0.0001]和急性充血性心力衰竭(OR 3.98，95%可信区间1.55~10.19，p=0.004)相关。转化生长因子-β1水平与左房内径(r=-0.30，p=0.007)、NT-proBNP(r=-0.14，p=0.007)呈负相关，低水平的转化生长因子-β1与房颤和心力衰竭相关。这种下降可能是由于受损心肌中转化生长因子-β1的高消耗或利钠肽的抗纤维化功能所致。
Atrial fibrillation (AF) and acute congestive heart failure (aCHF) are characterized by an adverse cardiac remodeling. Arrhythmogenic or structural remodeling can be caused by interstitial fibrosis. Transforming growth factor beta 1 (TGF-beta 1) represents a central regulator of cardiac fibrosis. This study investigates serum levels of TGF-beta 1 in patients with AF and aCHF.401 patients presenting with symptoms of dyspnea or peripheral edema were prospectively enrolled. Blood samples for measurement of TGF-beta 1 (R&D Systems, Inc.) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) (DadeBehring ltd.) were collected after the initial clinical evaluation.Median TGF-beta 1 levels were lower in patients with AF (21.0 ng/ml, interquartile range (IR) 15.4-27.6 ng/ml, n = 107) compared to those without (25.0 ng/ml, IR 18.5-31.6 ng/ml, n = 294) (p = 0.009). Patients with aCHF had lower TGF-beta 1 levels (median 22.0 ng/ml, IR 15.6-27.1 ng/ml, n = 122) than those without (median 24.9 ng/ml, IR 18.1-31.9 ng/ml, n = 279) (p = 0.0005). In logistic regression models TGF-beta 1 was still associated with AF (odds ratio (OR) 3.00, 95% CI 1.37-6.61, p = 0.0001) and aCHF (OR 3.98, 95% CI 1.55-10.19, p = 0.004). TGF-beta 1 inversely correlated with left atrial diameter (r = -0.30, p = 0.007) and NT-proBNP (r = -0.14, p = 0.007).Low serum levels of TGF-beta 1 are associated with AF and aCHF. This decrease may result from a higher consumption of TGF-beta 1 within the impaired myocardium or antifibrotic functions of natriuretic peptides.