HMGB1 as a predictor of infarct transmurality and functional recovery in patients with myocardial infarction
HMGB1 as a predictor of infarct transmurality and functional recovery in patients with myocardial infarction
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DOI：
10.1111/j.1365-2796.2011.02369.x
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发表时间：
2011-09-01
影响因子：
11.1
通讯作者：
Korosoglou, G.
中科院分区：
文献类型：
--
作者：
Andrassy, M.;Volz, H. C.;Korosoglou, G.
Andrassy M，Volz HC，Riedle N，Gitsioudis G，Seidel C，Laohachewin D，Zankl AR，卡亚Z，Bierhaus A，Giannitsis E，Katus HA，Korosoglou G（海德堡大学，海德堡，德国）.高迁移率族蛋白1可作为心肌梗死患者梗死透壁性和功能恢复的预测因子J Intern Med 2011; 270：245- 253. Objectives.高迁移率族蛋白1（HMGB 1）是一种先天性危险信号，启动宿主防御和组织修复。本研究旨在分析ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）患者血清HMGB 1浓度及其与梗死透壁性和功能恢复的相关性。我们前瞻性研究了根据现行指南治疗的首次STEMI（n = 46）或NSTEMI（n = 49）患者。在梗死后2-4天进行对比增强心脏磁共振成像以估计梗死透壁性，并在6个月后重复以估计残余左心室功能。梗死后2-4天测定HMGB 1。STEMI患者（r（2）= 0.81和r（2）= 0.40，P < 0.001）和NSTEMI患者（r（2）= 0.74和r（2）= 0.25，P < 0.001）的高迁移率族蛋白1浓度与梗死面积和残余射血分数相关。STEMI和NSTEMI患者的受试者工作特征（ROC）曲线的截止值分别为6.2和5.9 ng mL（-1），预测梗死透壁率大于75%（STEMI：曲线下面积（AUC）= 0.93，标准误（SE）= 0.04，95%置信区间（CI）= 0.81-0.98; NSTEMI：AUC = 0.96，SE = 0.04，95%CI = 0.86-0.99）。STEMI和NSTEMI患者的HMGB 1临界值分别为7.2和6.4 ng mL（-1），可预测心肌梗死（MI）后6个月的残余射血分数。（STEMI：AUC = 0.81，SE = 0.07，95%CI = 0.66-0.91; NSTEMI：AUC = 0.81，SE = 0.09，95%CI = 0.68-0.91）。高迁移率族蛋白1血清水平代表了一个非常有价值的替代标记物梗死透壁性和MI后残余左心室功能的预测。
Andrassy M, Volz HC, Riedle N, Gitsioudis G, Seidel C, Laohachewin D, Zankl AR, Kaya Z, Bierhaus A, Giannitsis E, Katus HA, Korosoglou G (University of Heidelberg, Heidelberg, Germany). HMGB1 as a predictor of infarct transmurality and functional recovery in patients with myocardial infarction. J Intern Med 2011; 270: 245-253.Objectives. High-mobility group box 1 (HMGB1) protein is an innate danger signal for the initiation of host defence and tissue repair. The aim of this study was to analyse serum HMGB1 concentration and its correlation with infarct transmurality and functional recovery in patients with ST-elevation (STEMI) and non-ST-elevation myocardial infarction(NSTEMI).Design. We prospectively examined patients with first-time STEMI (n = 46) or NSTEMI (n = 49), treated according to current guidelines. Contrast-enhanced cardiac magnetic resonance imaging was performed 2-4 days after infarction for the estimation of infarct transmurality and was repeated after 6 months for the estimation of residual left ventricular function. HMGB1 was measured 2-4 days after infarction.Results. High-mobility group box 1 concentration was related to infarct size and to residual ejection fraction in patients with STEMI (r(2) = 0.81 and r(2) = 0.40, respectively, P < 0.001 for both) and NSTEMI (r(2) = 0.74 and r(2) = 0.25, respectively, P < 0.001 for both). Receiver operating characteristic (ROC) curve-derived cut-off values of 6.2 and 5.9 ng mL(-1) for patients with STEMI and NSTEMI, respectively, were predictive of infarct transmurality greater than 75% (STEMI: area under the curve (AUC) = 0.93, standard error (SE) = 0.04, 95% confidence interval (CI) = 0.81-0.98; NSTEMI: AUC = 0.96, SE = 0.04, 95% CI = 0.86-0.99). HMGB1 cut-off values of 7.2 and 6.4 ng mL(-1) for patients with STEMI and NSTEMI, respectively, were predictive of residual ejection fraction 6 months after myocardial infarction (MI) (STEMI: AUC = 0.81, SE = 0.07, 95% CI = 0.66-0.91; NSTEMI: AUC = 0.81, SE = 0.09, 95% CI = 0.68-0.91).Conclusion. High-mobility group box 1 serum levels represent a highly valuable surrogate marker for infarct transmurality and for the prediction of residual left ventricular function after MI.