Soluble CD146 Is a Novel Marker of Systemic Congestion in Heart Failure Patients: An Experimental Mechanistic and Transcardiac Clinical Study

被引：38

作者：

Arrigo, Mattia ^{[1
,2
,3
,4
,5
]}

Truong, Quynh A. ^{[6
,7
,8
]}

Onat, Duygu ^{[9
]}

Szymonifka, Jackie ^{[6
,7
,8
]}

Gayat, Etienne ^{[1
,2
,3
]}

Tolppanen, Hell ^{[1
]}

Sadoune, Malha ^{[1
]}

Demmer, Ryan T. ^{[9
]}

Wong, Ka Y. ^{[9
]}

Launay, Jean Marie ^{[2
,10
]}

Samuel, Jane-Lise ^{[1
]}

Cohen-Solal, Alain ^{[1
,2
,4
]}

Januzzi, James L., Jr. ^{[8
]}

Singh, Jagmeet P. ^{[8
]}

Colombo, Paolo C. ^{[9
]}

Mebazaa, Alexandre ^{[1
,2
,3
]}

机构：

[1] INSERM, UMR S 942, Paris, France

[2] Univ Paris Diderot, PRES Sorbonne Paris Cite, Paris, France

[3] St Louis Lariboisiere Univ Hosp, AP HP, Dept Anesthesiol & Crit Care Med, Paris, France

[4] St Louis Lariboisiere Univ Hosp, AP HP, Dept Cardiol, Paris, France

[5] Univ Zurich Hosp, Dept Cardiol, Univ Heart Ctr, Zurich, Switzerland

[6] New York Presbyterian Hosp, Dalio Inst Cardiovasc Imaging, New York, NY USA

[7] Weill Cornell Med Coll, New York, NY USA

[8] Harvard Med Sch, Div Cardiol, Massachusetts Gen Hosp, Boston, MA USA

[9] Columbia Univ, Div Cardiol, Med Ctr, New York, NY USA

[10] Lariboisiere Univ Hosp, AP HP, Dept Biochem, Paris, France

来源：

CLINICAL CHEMISTRY | 2017年 / 63卷 / 01期

关键词：

RANDOMIZED CONTROLLED-TRIAL; EUROPEAN-SOCIETY; VENOUS CONGESTION; IDENTIFICATION; ASSOCIATION; ACTIVATION; BIOMARKER; ENDOTHELIUM; EXPRESSION; MANAGEMENT;

D O I：

10.1373/clinchem.2016.260471

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

BACKGROUND: Soluble CD146 (sCD146), is an endothelial marker with similar diagnostic power as natriuretic peptides in decompensated heart failure (HF). While natriuretic peptides are released by the failing heart, sCD146 may be released by veins in response to stretch induced by systemic congestion in HF. This study investigated the source, effects of vascular stress on release and prognostic properties of sCD146 in HF. METHODS: In a peripheral venous stress study, plasma concentrations of sCD146 and N-terminal probrain natriuretic-peptide (NT-proBNP) were measured in 44 HF patients at baseline and after 90 min of unilateral forearm venous congestion. In addition, sCD146 and NT-proBNP were measured in peripheral vein (PV) and coronary sinus (CS) blood samples of 137 HF patients and the transcardiac gradient was calculated. Those patients were followed for major adverse cardiovascular events (MACE) during 2 years. RESULTS: The induction of venous stress was associated with a pronounced increase in circulating concentrations of sCD146 in the congested arm (+60 mu g/L) compared to the control arm (+16 mu g/L, P = 0.025), while no difference in NT-proBNP concentrations was seen. In contrast to positive transcardiac gradient for NT-proBNP, median sCD146 concentrations were lower in CS than in PV (396 vs 434, P < 0.001), indicating a predominantly extracardiac source of sCD146. Finally, increased PV concentrations of sCD146 were associated with higher risk of MACE at 2 years. CONCLUSIONS: Soluble CD146 is released from the peripheral vasculature in response to venous stretch and may reflect systemic congestion in chronic HF patients. (C) 2016 American Association for Clinical Chemistry.

引用

页码：386 / 393

页数：8

共 28 条

[1] Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial [J].