Profiles of cardiovascular biomarkers according to severity stages of Chagas cardiomyopathy
Profiles of cardiovascular biomarkers according to severity stages of Chagas cardiomyopathy
复制标题
DOI：
10.1016/j.ijcard.2016.10.098
复制
发表时间：
2017-01-15
影响因子：
3.5
通讯作者：
Franco, Oscar H.
中科院分区：
文献类型：
--
作者：
Echeverria, Luis E.;Rojas, Lyda Z.;Franco, Oscar H.
背景/目的：高达30%至40%的Chagas患者表现出不同程度的心脏受累的心肌病。生物标志物可能有助于鉴别恰加斯心肌病（CCM）的严重程度。本研究旨在检查一组生物标志物的诊断价值，以区分（CCM）的严重程度。方法：对100例CCM患者进行横断面研究。根据心电图和超声心动图将CCM患者按病情严重程度分为3个阶段。测定高敏感性心肌肌钙蛋白T （Hs-cTnT）、n端前b型利钠肽（NT-proBNP）、半乳糖凝集素-3 （Gal-3）、中性粒细胞明胶酶相关脂钙蛋白（NGAL）、可溶性ST2 （sST2）和胱抑素-c （Cys-c）水平。使用逻辑回归模型来评估生物标志物的自然对数转换值水平与C/D和b阶段之间的关系。我们还计算了每个模型的曲线下面积（AUC）。结果：在年龄、性别、体重指数、肾功能和用药调整后的模型中，NT-proBNP水平升高(每1单位自然对数转换值，优势比(OR) = 5.55；95CI:1.65-18.72)和Hs-cTnT（每1单位自然对数转换值，OR = 7.11; 95CI%:1.41-35.90）显示与每1单位生物标志物增加的CCM严重程度显著相关。NT-proBNP和Hs-cTnT对CCM严重程度的诊断准确率较高，AUC分别为0.968和0.956。NT-proBNP与Hs-cTnT的AUC差异无统计学意义。Gal-3、NGAL、sST2和Cys-C与CCM严重程度无相关性。结论：NT-proBNP与Hs-cTnT在鉴别CCM严重程度上具有相同的诊断价值。(C) 2016由爱思唯尔爱尔兰有限公司出版。
Background/objectives: Up 30 to 40% of Chagas patients exhibit cardiomyopathy with different degrees of cardiac involvement. Biomarkers may help in differentiation of the severity of Chagas cardiomyopathy (CCM). This study sought to examine the diagnostic value of a panel of biomarkers to distinguish the severity of (CCM).Methods: 100 patients with CCM were included in this cross-sectional study. Based on electrocardiogram and echocardiogram, CCM patients were classified in three stages according to disease's severity. Levels of high sensitivity cardiac troponin T (Hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), soluble ST2 (sST2) and cystatin-c (Cys-c) were measured. Logistic regression models were used to assess the association between levels of natural log-transformed values of biomarkers and stages C/D versus B. We also calculated the area under curve (AUC) for each of the models.Results: In models adjusted for age, sex, body mass index, kidney function and medication use, increased levels of NT-proBNP (per 1 unit natural log-transformed values, odds ratio (OR) = 5.55; 95CI:1.65-18.72) and Hs-cTnT (per 1 unit natural log-transformed values, OR = 7.11; 95CI%:1.41-35.90) showed significant association with the severity of CCM per 1 unit increase of biomarkers. The accuracy of NT-proBNP and Hs-cTnT for diagnosis of the severity of CCM was high: AUC of 0.968 and 0.956 respectively. No significant difference was found in the AUC between NT-proBNP and Hs-cTnT. No association was found between Gal-3, NGAL, sST2 and Cys-C and severity of CCM.Conclusions: NT-proBNP and Hs-cTnT have both same diagnostic value in distinguishing severity of CCM. (C) 2016 Published by Elsevier Ireland Ltd.