Fibroblast Growth Factor 21 Correlates with the Prognosis of Dilated Cardiomyopathy
Fibroblast Growth Factor 21 Correlates with the Prognosis of Dilated Cardiomyopathy
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DOI：
10.1159/000509239
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发表时间：
2020-12-02
期刊：
影响因子：
1.9
通讯作者：
Ma, Genshan
中科院分区：
文献类型：
--
作者：
Gu, Lingyun;Jiang, Wenlong;Ma, Genshan
目的：本研究的目的是评估血清成纤维细胞生长因子21（FGF 21）水平是否可用于预测扩张型心肌病（DCM）的预后。方法：对241例扩张型心肌病患者和80例正常对照者进行平均16.12个月的随访。采用二维超声心动图技术计算左室舒张末期内径（LVEDD）和左室射血分数（LVEF）。在常规临床实验室检查中测定N末端B型利钠肽前体（NT-proBNP）和肌酐水平。采用酶联免疫吸附试验（ELISA）测定血清FGF 21水平。结果如下：DCM组的血清FGF 21水平显著高于对照组（225.85 +/- 32.57对145.36 +/- 30.57，p < 0.001）。血清FGF 21水平与心力衰竭（HF）NYHA心功能分级（r = 0.610，p < 0.001）和NT-proBNP水平（r = 0.741，p < 0.001）呈正相关。血清FGF 21水平与LVEF呈负相关（r =-0.402，p < 0.001）。FGF 21、NT-proBNP、LVEF和房颤（AF）病史与NYHA IV级显著相关（p < 0.05）。NT-proBNP预测DCM患者NYHA IV级的AUC大于FGF 21（0.830 vs. 0.772，p < 0.001）。总的来说，在终点记录了133例DCM患者。Kaplan-Meier分析结果显示，FGF 21和NT-proBNP水平高的个体的生存概率显著低于这些因子水平低的个体（p < 0.001）。在多变量考克斯分析中，FGF 21（HR 2.561; 95% CI 1.705-3.849）和NT-proBNP（HR 4.458; 95% CI 2.645-7.513）是DCM患者预后不良的独立预测因子。结论：血清FGF 21水平与DCM的危险因素、严重程度及预后有关。因此，FGF 21可能作为DCM预后的新生物标志物。
Objectives: The goal of this study was to evaluate whether serum fibroblast growth factor 21 (FGF21) levels can be used to predict the prognosis of dilated cardiomyopathy (DCM). Methods: 241 patients with DCM and 80 control subjects were recruited and followed up for an average of 16.12 months. A 2-dimensional (2-D) echocardiography technique was performed to calculate the left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) percentages. The levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatinine were measured in routine clinical laboratory tests. Serum FGF21 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: The levels of serum FGF21 were significantly higher in the DCM groups than in the control groups (225.85 +/- 32.57 vs. 145.36 +/- 30.57, p < 0.001). Serum FGF21 levels were positively correlated with the NYHA functional classification of heart failure (HF) (r = 0.610, p < 0.001) and NT-proBNP levels (r = 0.741, p < 0.001). Moreover, a negative correlation was observed between the serum FGF21 levels and the LVEF (r = -0.402, p < 0.001). FGF21, NT-proBNP, the LVEF and a history of atrial fibrillation (AF) correlated significantly with NYHA class IV (p < 0.05). The AUC of NT-proBNP for predicting NYHA class IV in DCM patients was greater than that of FGF21 (0.830 vs. 0.772, p < 0.001). Overall, 133 patients with DCM were recorded at the end point. Kaplan-Meier analysis results showed that the survival probability of those individuals with high levels of FGF21 and NT-proBNP was significantly lower than of those with low levels of these factors (p < 0.001). In the multivariate Cox analysis, FGF21 (HR 2.561; 95% CI 1.705-3.849) and NT-proBNP (HR 4.458; 95% CI 2.645-7.513) were independent predictors of a poor prognosis in DCM patients. Conclusions: Serum FGF21 levels were associated with the risk factors, severity, and prognosis of DCM. Therefore, FGF21 may serve as a novel biomarker for the prognosis of DCM.