Plasma CCN2/connective tissue growth factor is associated with right ventricular dysfunction in patients with neuroendocrine tumors.
Plasma CCN2/connective tissue growth factor is associated with right ventricular dysfunction in patients with neuroendocrine tumors.
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DOI：
10.1186/1471-2407-10-6
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发表时间：
2010-01-06
期刊：
影响因子：
3.8
通讯作者：
Edvardsen T
中科院分区：
文献类型：
--
作者：
Bergestuen DS;Gravning J;Haugaa KH;Sahakyan LG;Aakhus S;Thiis-Evensen E;Øie E;Aukrust P;Attramadal H;Edvardsen T
类癌性心脏病是一种已知的神经内分泌肿瘤并发症，其特征是右心纤维化病变。传统上，类癌性心脏病的定义是瓣膜受累的程度。右心室（RV）功能障碍，由于壁参与也可能是一种表现。结缔组织生长因子（CCN 2）在许多纤维化疾病中升高。它在类癌性心脏病中的作用尚不清楚。我们试图研究类癌性心脏病中血浆CCN 2与瓣膜和壁受累之间的关系。对69例神经内分泌肿瘤患者进行了超声心动图检查。采用组织多普勒心肌收缩应变分析评价右室功能。采用酶联免疫吸附试验分析血浆CCN 2。适当时，使用Mann-Whitney U、Kruskal-Wallis、卡方和Fisher精确检验比较各组。线性回归用于评估相关性。平均应变为-21% ± 5。33例患者右心室功能下降（应变>-20%，平均-16% ± 3）。其中，8例没有或有极轻微的三尖瓣和/或肺动脉返流（TR/PR）。36例患者右心室功能正常或轻度降低（应变≤-20%，平均-25% ± 3）。RV功能与血浆CCN 2水平呈显著负相关（r = 0.47，p < 0.001）。RV功能降低的患者血浆CCN 2水平高于RV功能正常或轻度降低的患者（p < 0.001）。血浆CCN 2 ≥ 77 μg/L是RV功能降低的独立预测因子（比值比15.36 [95% CI 4.15;56.86]），其检测灵敏度为88%，特异性为69%（p < 0.001）。与无TR/PR或TR/PR最低的患者相比，轻度或更高TR/PR患者的血浆CCN 2升高（p = 0.008），中度至重度TR/PR患者的血浆CCN 2水平最高（p = 0.03）。血浆CCN 2水平升高与NET患者的RV功能障碍和瓣膜返流相关。CCN 2可能在神经内分泌肿瘤相关的心脏纤维化中发挥作用，并可能作为其最早阶段的标志物。
Carcinoid heart disease, a known complication of neuroendocrine tumors, is characterized by right heart fibrotic lesions. Carcinoid heart disease has traditionally been defined by the degree of valvular involvement. Right ventricular (RV) dysfunction due to mural involvement may also be a manifestation. Connective tissue growth factor (CCN2) is elevated in many fibrotic disorders. Its role in carcinoid heart disease is unknown. We sought to investigate the relationship between plasma CCN2 and valvular and mural involvement in carcinoid heart disease. Echocardiography was performed in 69 patients with neuroendocrine tumors. RV function was assessed using tissue Doppler analysis of myocardial systolic strain. Plasma CCN2 was analyzed using an enzyme-linked immunosorbent assay. Mann-Whitney U, Kruskal-Wallis, Chi-squared and Fisher's exact tests were used to compare groups where appropriate. Linear regression was used to evaluate correlation. Mean strain was -21% ± 5. Thirty-three patients had reduced RV function (strain > -20%, mean -16% ± 3). Of these, 8 had no or minimal tricuspid and/or pulmonary regurgitation (TR/PR). Thirty-six patients had normal or mildly reduced RV function (strain ≤ -20%, mean -25% ± 3). There was a significant inverse correlation between RV function and plasma CCN2 levels (r = 0.47, p < 0.001). Patients with reduced RV function had higher plasma CCN2 levels than those with normal or mildly reduced RV function (p < 0.001). Plasma CCN2 ≥ 77 μg/L was an independent predictor of reduced RV function (odds ratio 15.36 [95% CI 4.15;56.86]) and had 88% sensitivity and 69% specificity for its detection (p < 0.001). Plasma CCN2 was elevated in patients with mild or greater TR/PR compared to those with no or minimal TR/PR (p = 0.008), with the highest levels seen in moderate to severe TR/PR (p = 0.03). Elevated plasma CCN2 levels are associated with RV dysfunction and valvular regurgitation in NET patients. CCN2 may play a role in neuroendocrine tumor-related cardiac fibrosis and may serve as a marker of its earliest stages.
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影响因子：
2.7
作者：
Kubota, S;Kawata, K;Takigawa, M
通讯作者：
Takigawa, M
影响因子：
5
作者：
Ahmed, MS;Oie, E;Attramadal, H
通讯作者：
Attramadal, H
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4.4
作者：
He, Shikun;Chen, Youxin;Hinton, David R.
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Hinton, David R.
影响因子：
13.3
作者：
Dziadzio, M;Usinger, W;Stratton, R
通讯作者：
Stratton, R
影响因子：
37.8
作者：
Helle-Valle, T;Crosby, J;Smiseth, OA
通讯作者：
Smiseth, OA