Circulation:高敏心肌肌钙蛋白T可以反应早期亚临床心力衰竭

2017-02-11 MedSci MedSci原创

虽然高敏感性心肌肌钙蛋白T(hs-cTnT)的增高与事件性心力衰竭(HF)相关,但是这种相关性的潜在机制没有很好地研究。评估hs-cTnT与替代性纤维化的关系以及发生症状之前的结构性心脏病的进展对于理解该生物标志物在HF的预防策略中至关重要。近期,一项发表在杂志Circulation上的文章研究了这一问题。研究者们测量了4,986名参与者的基线hs-cTnT,这些受试者均参与动脉粥样硬化的多种族研

虽然高敏感性心肌肌钙蛋白T(hs-cTnT)的增高与事件性心力衰竭(HF)相关,但是这种相关性的潜在机制没有很好地研究。评估hs-cTnT与替代性纤维化的关系以及发生症状之前的结构性心脏病的进展对于理解该生物标志物在HF的预防策略中至关重要。


近期,一项发表在杂志Circulation上的文章研究了这一问题。

研究者们测量了4,986名参与者的基线hs-cTnT,这些受试者均参与动脉粥样硬化的多种族研究(MESA),该受试者最初没有明显的心血管疾病(CVD)。在基线进行心脏磁共振(CMR)成像。10年后,在2,831名参与者中重复CMR检查,他们均没有发生CVD事件;而这些受试者中的1,723名接受钆增强CMR,通过晚期钆增强(LGE)描述替代纤维化。亚临床CVD的进展定义为左心室结构和功能在10年间的变化。使用Cox回归模型估计hs-cTnT与HF、CV相关死亡率和冠心病的相关性。

此项研究结果显示:通过随访CMR检测,没有临床CVD事件的参与者中有6.3%出现替代性纤维化的LGE。在高基线水平的hs-cTnT类别和LGE中观察到分级相关性(≥7.42ng/ L vs. 检测极限[LOD:<3ng / L],调整优势比[OR] = 2.87,95%CI:1.38,5.94)。更高的hs-cTnT水平也与LV质量> 12%增加的可能性相关(最高类别vs

此项研究结果表明:hs-cTnT水平与无CVD成人中的替代性纤维化和LV结构的进行性变化相关,这一现象可能在HF出现症状之前的很多年发生。 hs-cTnT的轻度升高可以代表早期亚临床心脏病的生化标志,可以提供靶向预防性干预的机会。

原始出处:
Seliger SL, Hong SN, Christenson RH, et al. High Sensitive Cardiac Troponin T as an Early Biochemical Signature for Clinical and Subclinical Heart Failure: The Multi-Ethnic Study of Atherosclerosis. Circulation. 2017 Feb 3. pii: CIRCULATIONAHA.116.025505.

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    2017-02-16 1771ae4158m

    学习一下很不错

    0

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    2017-02-11 1e15b6fem30(暂无匿称)

    很好的学习资料,感谢了。

    0

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