Reversal of IFN-γ, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy
Reversal of IFN-γ, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy
复制标题
DOI：
10.1016/j.ejheart.2008.07.005
复制
发表时间：
2008-09-01
影响因子：
18.2
通讯作者：
Sliwa, Karen
中科院分区：
文献类型：
--
作者：
Forster, Olaf;Hilfiker-Kleiner, Denise;Sliwa, Karen
目的：围产期心肌病（PPCM）以急性心衰为特征，病因不明。我们的目的是确定参与疾病发生和发展的机制。方法与结果：对PPCM患者和健康对照组的心功能、细胞凋亡、氧化应激、重构、炎症及护理激素催乳素等血清标志物进行分析。在6个月的随访中，比较了心功能改善患者（IMP）和未改善患者（NIMP）之间这些标志物的动力学。所有患者均接受了ace抑制剂、受体阻滞剂和利尿剂治疗。tgf - β -1基线水平显著降低，MMP-9、VEGF无显著差异；与对照组相比，PPCM组其他指标均显著升高。NIMP患者只有NT-proBNP基线水平高于IMP患者。6个月后，IMP患者NT-proBNP、oxLDL和ifn - γ水平显著降低，IMP患者oxLDL、ifn - γ和催乳素水平显著降低，而NIMP患者则无显著降低。PPCM患者NT-proBNP、oxLDL、催乳素和ifn - γ的动力学之间存在显著相关性。结论：基线NT-proBNP和不能降低oxLDL、ifn - γ和催乳素与PPCM的不良预后相关，提示这些因素在PPCM的病理生理和PPCM患者的风险分层中可能起作用。(C) 2008年欧洲心脏病学会。Elsevier B.V.版权所有。
Aim: Peripartum cardiomyopathy (PPCM) is characterized by acute onset of heart failure of unknown aetiology. We aimed to identify mechanisms involved in initiation and progression of the disease.Methods and results: Serum markers related to cardiac function, apoptosis, oxidative stress, remodelling, inflammation and the nursing hormone prolactin were analyzed in PPCM patients and healthy controls. The kinetics of these markers were compared between patients who improved cardiac function (IMP) and those patients who did not improve (NIMP), over 6 months follow-up. All patients received ACE-inhibitors, beta-blockers and diuretics. Baseline levels of TGF-beta-1 were significantly lower, MMP-9 and VEGF were not different; all other markers were significantly higher in PPCM compared with controls. Only baseline NT-proBNP levels were higher in NIMP compared with IMP. After 6 months, NT-proBNP, oxLDL and IFN-gamma were significantly lower in IMP and the decrease in oxLDL, IFN-gamma and prolactin was significant in IMP but not in NIMP. Significant correlations were observed between the kinetics of NT-proBNP, oxLDL, prolactin and IFN-gamma in PPCM patients.Conclusion: Baseline NT-proBNP and the failure to decrease oxLDL, IFN-gamma and prolactin are associated with poor outcome in PPCM, suggesting a potential role of these factors in the pathophysiology of PPCM and for risk stratification of PPCM patients. (C) 2008 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.