冠心病患者sST2、Gal-3水平与心肌纤维化的相关性研究

张玉莲, 邓玮, 王云会, 陈诗语, 郑芳

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重庆医科大学学报 ›› 2024, Vol. 49 ›› Issue (01) : 37-43. DOI: 10.13406/j.cnki.cyxb.003378
临床研究 DOI:10.13406/j.cnki.cyxb.003378

冠心病患者sST2、Gal-3水平与心肌纤维化的相关性研究

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Correlation of soluble growth stimulation expressed gene 2 and galectin-3 with myocardial fibrosis in patients with coronary artery disease

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摘要

目的 探讨冠心病(coronary artery disease,CAD)患者可溶性生长刺激表达基因2蛋白(soluble growth stimulation expressed gene 2,sST2)、半乳糖凝集素-3(galectin-3,Gal-3)与心肌纤维化(myocardial fibrosis,MF)的关系,指导临床缺血性MF的评估。 方法 以顺序入选2021年9月至2022年9月在重庆医科大学附属第二医院科住院的冠心病受试者56例非冠心病患者31例为研究对象,根据心血管磁共振-延迟钆增强(cardiovascular magnetic resonance-late gadolinium enhancement,CMR-LGE)将冠心病组分为心肌纤维化(LGE阳性)亚组和非心肌纤维化(LGE阴性)亚组。收集所有受试者的一般临床资料。所有受试者均通过酶联免疫吸附法测定血清sST2、Gal-3水平。分析sST2、Gal-3与CMR-LGE结果的相关性。 结果 ①CAD组患者sST2、Gal-3、血压、肌酐、尿酸、室间隔厚、糖化血红蛋白、CAS评分高于非CAD组患者(P<0.05),而肾小球滤过率、高密度脂蛋白低于非CAD患者(P<0.05)。②LGE阳性亚组sST2、Gal-3、B型利钠肽原水平较LGE阴性亚组高(P<0.05),高密度脂蛋白较LGE阴性亚组低(P<0.05)。③LGE与sST2(rs =0.338,P=0.011)、Gal-3(rs =0.428,P=0.001)、B型利钠肽原(rs =0.364,P=0.006)呈正相关,与高密度脂蛋白(rs =-0.339,P=0.011)呈负相关,纳入控制变量进行偏相关分析得出LGE与sST2(r=0.312,P=0.037)、Gal-3(r=0.419,P=0.004)独立相关。④sST2、Gal-3以及两者联合检测心肌纤维化的敏感度分别是65%、87%、70%,特异度分别是81%、56%、87%,sST2、Gal-3预测有无心肌纤维化的最佳临界值分别是36.01 ng/mL、13.04 ng/mL。 结论 sST2、Gal-3可用于预测缺血性心肌纤维化,与CMR-LGE评估心肌纤维化具有高度一致性。

Abstract

Objective To investigate the correlation of soluble growth stimulation expressed gene 2(sST2) and galectin-3(Gal-3) with myocardial fibrosis(MF) in patients with coronary artery disease(CAD),and to guide the evaluation of ischemic MF in clinical practice. Methods A total of 56 patients with CAD and 31 patients without CAD who were hospitalized in our department from September 2021 to September 2022 were enrolled as subjects,and according to the results of cardiovascular magnetic resonance-late gadolinium enhancement(CMR-LGE),the CAD group was further divided into MF(LGE positive) subgroup and non-MF(LGE negative) subgroup. General clinical data were collected from all subjects,and ELISA was used to measure the serum levels of sST2 and Gal-3. The correlation of sST2 and Gal-3 with CMR-LGE results was analyzed. Results Compared with the non-CAD group,the CAD group had significantly higher levels of sST2 and Gal-3,blood pressure,creatinine,uric acid,interventricular septum thickness,glycosylated hemoglobin,and CAS score(P<0.05) and significantly lower glomerular filtration rate and high-density lipoprotein(P<0.05). Compared with the LGE-negative subgroup,the LGE-positive subgroup had significantly higher levels of sST2,Gal-3,and pro-B-type natriuretic peptide(P<0.05) and a significantly lower level of high-density lipoprotein(P<0.05). LGE was positively correlated with sST2(rs =0.338,P=0.011),Gal-3(rs =0.428,P=0.001),and pro-B-type natriuretic peptide(rs =0.364,P=0.006) and was negatively correlated with high-density lipoprotein(rs =-0.339,P=0.011),and the partial correlation analysis with control variables showed that LGE was independently correlated with sST2(r=0.312,P=0.037) and Gal-3(r=0.419,P=0.004). The analysis showed that sST2 or Gal-3 used alone or in combination had a sensitivity of 65%,87%,and 70%,respectively,and a specificity of 81%,56%,and 87%,respectively,in detecting MF,and sST2 and Gal-3 had an optimal cut-off value of 36.01 ng/mL and 13.04 ng/mL,respectively,in predicting the presence or absence of ischemic MF. Conclusion This study shows that sST2 and Gal-3 can be used to predict ischemic MF and are highly consistent with CMR-LGE in evaluating MF.

关键词

心肌纤维化 / 冠心病 / 可溶性生长刺激表达基因2蛋白 / 半乳糖凝集素-3

Key words

myocardial fibrosis / coronary heart disease / soluble growth stimulation expressed gene 2 / galectin-3

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R542

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张玉莲 , 邓玮 , 王云会 , . 冠心病患者sST2、Gal-3水平与心肌纤维化的相关性研究. 重庆医科大学学报. 2024, 49(01): 37-43 https://doi.org/10.13406/j.cnki.cyxb.003378
Zhang Yulian, Deng Wei, Wang Yunhui, et al. Correlation of soluble growth stimulation expressed gene 2 and galectin-3 with myocardial fibrosis in patients with coronary artery disease[J]. Journal of Chongqing Medical University. 2024, 49(01): 37-43 https://doi.org/10.13406/j.cnki.cyxb.003378

参考文献

1
Osokina A Karetnikova V Polikutina O,et al. Prognostic potential of cardiac structural and functional parameters and N-terminal propeptide of type III procollagen in predicting cardiac fibrosis one year after myocardial infarction with preserved left ventricular ejection fraction[J]. Aging202113(1):194-203.
2
Rorabaugh B Mabe N Seeley S,et al. Myocardial fibrosis,inflammation,and altered cardiac gene expression profiles in rats exposed to a predator-based model of posttraumatic stress disorder[J]. Stress(Amsterdam,Netherlands)202023(2):125-135.
3
Gupta S Ge Y Singh A,et al. Multimodality Imaging Assessment of Myocardial Fibrosis[J]. JACC. Cardiovascular imaging202114(12):2457-2469.
4
Salvador D Gamba M Gonzalez-Jaramillo N,et al. Diabetes and Myocardial Fibrosis:A Systematic Review and Meta-Analysis[J]. JACC. Cardiovascular imaging202215(5):796-808.
5
Kanagala P Cheng A Singh A,et al. Relationship Between Focal and Diffuse Fibrosis Assessed by CMR and Clinical Outcomes in Heart Failure With Preserved Ejection Fraction[J]. JACC. Cardiovascular imaging201912:2291-2301.
6
Frangogiannis N. Cardiac fibrosis[J]. Cardiovascular research2021117(6):1450-1488.
7
Vértes V Porpáczy A Nógrádi Á,et al. Galectin-3 and sST2:associations to the echocardiographic markers of the myocardial mechanics in systemic sclerosis - a pilot study[J]. Cardiovascular ultrasound202220(1):1.
8
Dudek M Kałużna-Oleksy M Migaj J,et al. sST2 and Heart Failure-Clinical Utility and Prognosis[J]. Journal of clinical medicine202312(9):3136.
9
李春兰,贺延平,何 瑾. 新型生物标记物在心力衰竭患者中的研究进展[J]. 中国心血管病研究202119(12):1095-1098.
Li CL He YP He J. Research progress of novel biomarkers in patients with heart failure[J]. Chinese Journal of Cardiovascular Research202119(12):1095-1098.
10
Matilla L Arrieta V Jover E,et al. Soluble St2 Induces Cardiac Fibroblast Activation and Collagen Synthesis via Neuropilin-1[J]. Cells20209(7):9071667.
11
Matilla L Ibarrola J Arrieta V,et al. in vitroSoluble ST2 promotes oxidative stress and inflammation in cardiac fibroblasts:an and study in aortic stenosis[J]. Clinical science(London,England: 1979),2019,133(14):1537-1548.
12
Ding Z Du W Lei Z,et al. Neuropilin 1 modulates TGF‑β1‑induced epithelial‑mesenchymal transition in non‑small cell lung cancer[J]. International journal of oncology202056(2):531-543.
13
Pratama R Hartopo A Anggrahini D,et al. Serum soluble suppression of tumorigenicity-2 level associates with severity of pulmonary hypertension associated with uncorrected atrial septal defect[J]. Pulmonary circulation202010(2):2045894020915832.
14
Geenen L Baggen V Kauling R,et al. The Prognostic Value of Soluble ST2 in Adults with Pulmonary Hypertension[J]. Journal of clinical medicine20198(10):15-17.
15
Obradovic DM Büttner P Rommel KP,et al. Soluble ST2 Receptor:Biomarker of Left Ventricular Impairment and Functional Status in Patients with Inflammatory Cardiomyopathy[J]. Cells202211(3):11030414.
16
Blanda V Bracale U Di Taranto M,et al. Galectin-3 in Cardiovascular Diseases[J]. International journal of molecular sciences202021(23):21239232.
17
Cao Z Yu X Leng P. Research progress on the role of gal-3 in cardio/cerebrovascular diseases[J]. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie2021133:111066.
18
Ureche C Dodi G Covic A,et al. Connection between Cardiac Fibrosis Biomarkers and Echocardiography Parameters in Advanced Chronic Kidney Disease Patients[J]. Journal of clinical medicine202312(8):3003.
19
王彦玲,王燕庆,刘东霞,等. 半乳糖凝集素3在心血管疾病中的研究进展[J]. 中华老年心脑血管病杂志202123(11):1221-1223.
Wang YL Wang YQ Liu DX,et al. Research progress of Galectin-3 in cardiovascular diseases[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases202123(11):1221-1223.
20
Hara A Niwa M Kanayama T,et al. Galectin-3:A Potential Prognostic and Diagnostic Marker for Heart Disease and Detection of Early Stage Pathology[J]. Biomolecules202010(9):1277.
21
Lyngbakken M Myhre P Røsjø H,et al. Novel biomarkers of cardiovascular disease:Applications in clinical practice[J]. Critical reviews in clinical laboratory sciences201956(1):33-60.
22
Zhong X Qian X Chen G,et al. The role of galectin-3 in heart failure and cardiovascular disease[J]. Clinical and experimental pharmacology & physiology201946(3):197-203.
23
Sun Z Zhang L Li L,et al. Galectin-3 mediates cardiac remodeling caused by impaired glucose and lipid metabolism through inhibiting two pathways of activating Akt[J]. American journal of physiology. Heart and circulatory physiology2021320(1):H364-H380.
24
Li S Li S Hao X,et al. Perindopril and a Galectin-3 Inhibitor Improve Ischemic Heart Failure in Rabbits by Reducing Gal-3 Expression and Myocardial Fibrosis[J]. Frontiers in physiology201910:267.
25
Akin S Kubat G Guray U,et al. Possible value of galectin-3 on follow-up of cardiac remodeling during glucocorticoid treatment[J]. Journal of biochemical and molecular toxicology202135(4):e22717.
26
Aksan G Gedikli Ö Keskin K,et al. Is galectin-3 a biomarker,a player-or both-in the presence of coronary atherosclerosis?[J]. Journal of investigative medicine:the official publication of the American Federation for Clinical Research201664(3):764-770.
27
Szadkowska I Wlazeł R Migała M,et al. The association between galectin-3 and clinical parameters in patients with first acute myocardial infarction treated with primary percutaneous coronary angioplasty[J]. Cardiology journal201320(6):577-582.
28
Yakar Tülüce S Tülüce K Çil Z,et al. Galectin-3 levels in patients with hypertrophic cardiomyopathy and its relationship with left ventricular mass index and function[J]. Anatolian journal of cardiology201616(5):344-348.

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重庆市科卫联合医学科研资助项目(2021MSXM094)

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