Neurohormonal Activation in Acute Heart Failure: Results from VERITAS
Neurohormonal Activation in Acute Heart Failure: Results from VERITAS
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DOI：
10.1159/000330409
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发表时间：
2011-01-01
期刊：
影响因子：
1.9
通讯作者：
Cotter-Davison, Gad
中科院分区：
文献类型：
--
作者：
Milo-Cotter, Olga;Cotter-Davison, Beth;Cotter-Davison, Gad
目的：最近的心力衰竭研究表明，急性失代偿性心力衰竭期间，炎症和免疫系统激活与细胞因子、趋化因子和炎症蛋白水平升高有关。本亚组研究的目的是评估神经激素和炎症激活在急性心力衰竭（AHF）发病机制和结果中的作用以及生物标志物水平与临床结果之间的相关性。方法：在基线、24 小时、48 小时和 7 小时测量 B 型利钠肽 32 (BNP-32)、内皮素 1 (ET-1)、去甲肾上腺素、肌钙蛋白 I 和 T、C 反应蛋白 (CRP)、血管性血友病因子、纤溶酶原激活剂抑制剂 1、白细胞介素 6 (IL-6) 和组织纤溶酶原激活剂 (TPA) 的血清水平。以及 30 天招募的 112 名 AHF 患者参加 Tezosentan 抑制内皮素受体在急性心力衰竭中的价值神经激素亚研究。结果：根据单变量分析，CRP、BNP 和 ET-1 可预测第 30 天心力衰竭恶化；综合考虑时，只有 CRP 和 BNP 与这一结果显着相关。调整年龄、基线血压、血清钠和血清肌酐后，只有年龄和 BNP 仍然显着。单变量分析表明，CRP、IL-6 和 TPA 水平与 180 天死亡率显着相关。结论：循环炎症标志物可能有助于评估 AHF 患者的预后。版权所有 (C) 2011 S. Karger AG，巴塞尔
Objectives: Recent heart failure studies have suggested that inflammatory and immune system activation are associated with increased levels of cytokines, chemokines and inflammatory proteins during acutely decompensated heart failure. The objectives of this substudy were to evaluate the role of neurohormonal and inflammatory activation in the pathogenesis and outcome of acute heart failure (AHF) and the correlation between biomarker levels and clinical outcomes. Methods: Serum levels of B-type natriuretic peptide-32 (BNP-32), endothelin-1 (ET-1), norepinephrine, troponins I and T, C-reactive protein (CRP), von Willebrand factor, plasminogen activator inhibitor-1, interleukin-6 (IL-6) and tissue plasminogen activator (TPA) were measured at baseline, 24 and 48 h and 7 and 30 days in 112 patients with AHF recruited to the Value of Endothelin Receptor Inhibition with Tezosentan in Acute Heart Failure Study neurohormonal substudy. Results: On univariable analysis, CRP, BNP and ET-1 were predictive of worsening heart failure by day 30; when considered together, only CRP and BNP were significantly associated with this outcome. On adjustment for age, baseline blood pressure, serum sodium and serum creatinine, only age and BNP remained significant. CRP, IL-6 and TPA levels were significantly correlated with 180-day mortality on univariable analysis. Conclusion: Circulating markers of inflammation may be useful in gauging prognosis in patients with AHF. Copyright (C) 2011 S. Karger AG, Basel