Stabilization of Cardiac Function With Diflunisal in Transthyretin (ATTR) Cardiac Amyloidosis.
Stabilization of Cardiac Function With Diflunisal in Transthyretin (ATTR) Cardiac Amyloidosis.
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DOI：
10.1016/j.cardfail.2019.11.024
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发表时间：
2020-09
影响因子：
6
通讯作者：
Ruberg FL
中科院分区：
文献类型：
--
作者：
Lohrmann G;Pipilas A;Mussinelli R;Gopal DM;Berk JL;Connors LH;Vellanki N;Hellawell J;Siddiqi OK;Fox J;Maurer MS;Ruberg FL
甲状腺素运载蛋白淀粉样变性心肌病（ATTR-CM）是由错误折叠的TTR（前白蛋白）蛋白引起的心力衰竭的一个未被充分认识的原因。二氟尼柳是一种批准的非甾体抗炎药，可稳定TTR，对心脏结构和功能影响的数据有限。回顾性确定ATTR-CM患者（n=81，41%根据临床实践接受250 mg每日两次二氟尼柳治疗），比较基线和随访（中位间隔1年）血清生物标志物和超声心动图数据，包括整体纵向应变（GLS）。卡方和Wilcoxon检验评估了受试者之间的差异，按治疗组分组，并进行了单变量和多变量线性回归。基线时，接受二氟尼柳治疗的患者年龄较小，（68 vs 77岁，P = .0001），B型利钠肽水平较低（BNP; 249 vs 545 pg/mL，P = .009）和血清肌酐（1.1 vs 1.2 mg/dL，P = 0.04），但TTR浓度（P = 0.31）、心肌肌钙蛋白I（P = 0.06）和GLS（P = 0.67）相似。随访时，整个队列中，二氟尼柳未治疗与治疗患者的TTR浓度存在差异（19 vs 33 mg/dL，P = 0.01），左心房容积指数（+4.6 vs-1.4 mL/m2，P = 0.002）和心肌肌钙蛋白I（+0.03 vs-0.01 ng/mL，P = 0.01）也存在有利差异。在野生型ATTR亚组（n=53）中，二氟尼柳治疗与GLS差异相关（未治疗组+1.2% vs治疗组+0.1%，P = 0.03）。两组间室壁厚度（P = .2）、左心室射血分数（P = .71）和BNP（P = .42）的变化相似。在ATTR-CM中，仅在给药1年后，二氟尼柳治疗导致心脏结构和功能的一些参数出现可测量的差异。需要进一步的长期分析。
Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is an underappreciated cause of heart failure that results from misfolded TTR (prealbumin) protein. Diflunisal is an approved non-steroidal anti-inflammatory drug that stabilizes TTR, with limited data available regarding effects on cardiac structure and function. ATTR-CM patients (n=81, 41% treated with 250 mg twice-daily diflunisal by clinical practice) were retrospectively identified with baseline and follow-up (median interval 1 year) serum biomarker and echocardiographic data compared, including global longitudinal strain (GLS). Chi-squared and Wilcoxon tests assessed differences between subjects, divided by treatment group, and univariable and multivariable linear regression was performed. At baseline, patients treated with diflunisal were younger (68 vs 77 years, P = .0001), with lower B-type natriuretic peptide (BNP; 249 vs 545 pg/mL, P = .009) and serum creatinine (1.1 vs 1.2 mg/dL, P = .04), but similar TTR concentration (P = .31), cardiac troponin I (P = .06), and GLS (P = .67). At follow-up, diflunisal untreated versus treated patients showed differences in TTR concentration (19 vs 33 mg/dL, P = .01) and favorable differences in left atrial volume index (+4.6 vs −1.4 mL/m2, P = .002) and cardiac troponin I (+0.03 vs −0.01 ng/mL, P = .01) for the entire cohort. Among the subset with wild-type ATTR (n=53), diflunisal treatment was associated with differences in GLS (+1.2% untreated vs +0.1% treated, P = .03). Changes in wall thickness (P = .2), left ventricular ejection fraction (P = .71), and BNP (P = .42) were similar between groups. In ATTR-CM, diflunisal treatment resulted in measurable differences in some parameters of cardiac structure and function after only 1 year of administration. Further longer-term analysis is warranted.
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影响因子：
120.7
作者：
Berk, John L.;Suhr, Ole B.;Obici, Laura;Sekijima, Yoshiki;Zeldenrust, Steven R.;Yamashita, Taro;Heneghan, Michael A.;Gorevic, Peter D.;Litchy, William J.;Wiesman, Janice F.;Nordh, Erik;Corato, Manuel;Lozza, Alessandro;Cortese, Andrea;Robinson-Papp, Jessica;Colton, Theodore;Rybin, Denis V.;Bisbee, Alice B.;Ando, Yukio;Ikeda, Shu-ichi;Seldin, David C.;Merlini, Giampaolo;Skinner, Martha;Kelly, Jeffery W.;Dyck, Peter J.
通讯作者：
Dyck, Peter J.
DOI：
10.1161/circheartfailure.117.004769
发表时间：
2018-04
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Rosenblum H;Castano A;Alvarez J;Goldsmith J;Helmke S;Maurer MS
通讯作者：
Maurer MS
DOI：
10.1016/j.ijcha.2015.07.010
发表时间：
2015-12-07
期刊：
International journal of cardiology. Heart & vasculature
影响因子：
--
作者：
Koyama J;Minamisawa M;Sekijima Y;Ikeda SI;Kozuka A;Ebisawa S;Miura T;Motoki H;Okada A;Izawa A;Ikeda U
通讯作者：
Ikeda U
影响因子：
39.3
作者：
Gillmore, Julian D.;Damy, Thibaud;Hawkins, Philip N.
通讯作者：
Hawkins, Philip N.
影响因子：
37.8
作者：
Solomon, Scott D.;Adams, David;Suhr, Ole
通讯作者：
Suhr, Ole