Profiles of cardiovascular biomarkers according to severity stages of Chagas cardiomyopathy

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• 作者：Luis E. Echeverrí ; a^a ; ¹ ; ² ; ^{luisecheverria@fcv.org} ; ^{luisedo10@gmail.com} ; Lyda Z. Rojas^b ; ^c ; ^d ; ¹ ; ³ ; ^{l.rojassanchez@erasmusmc.nl} ; ^{lydarojas@fcv.org} ; Lauren S. Calvo^d ; ² ; ^{laurencalvo@fcv.org} ; Zayne M. Roa^d ; ² ; ^{zayneroa@fcv.org} ; Oscar L. Rueda-Ochoa^c ; ^e ; ⁴ ; ^{o.ruedaochoa@erasmusmc.nl} ; Carlos A. Morillo^f ; ⁵ ; ^{morillo@hhsc.ca} ; Taulant Muka^c ; ⁴ ; ^{t.muka@erasmusmc.nl} ; Oscar H. Franco^c ; ⁶ ; ^{o.franco@erasmusmc.nl}
• 关键词：AUC-ROC ; area under the receiver operating characteristic curve ; CCM ; Chagas cardiomyopathy ; Cys-c ; cystatin c ; ECG ; electrocardiographic ; Echo ; echocardiographic ; eGFR ; estimated glomerular filtration rate ; Gal-3 ; galectin-3 ; HF ; heart failure ; Hs-cTnT ; high sensitivity troponin T ; LVEF ; left ventricular ejection fraction ; NGAL ; neutrophil gelatinase-associated lipocalin ; NT-proBNP ; N-terminal fragment of the pro B-type natriuretic peptide ; sST2 ; soluble ST2
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：577-582
• 全文大小：475 K
• 卷排序：227

文摘

Up 30 to 40% of Chagas patients exhibit cardiomyopathy with different degrees of cardiac involvement. Biomarkers may help in differentiation of the severity of Chagas cardiomyopathy (CCM). This study sought to examine the diagnostic value of a panel of biomarkers to distinguish the severity of (CCM).Methods100 patients with CCM were included in this cross-sectional study. Based on electrocardiogram and echocardiogram, CCM patients were classified in three stages according to disease's severity. Levels of high-sensitivity cardiac troponin T (Hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), soluble ST2 (sST2) and cystatin-c (Cys-c) were measured. Logistic regression models were used to assess the association between levels of natural log-transformed values of biomarkers and stages C/D versus B. We also calculated the area under curve (AUC) for each of the models.ResultsIn models adjusted for age, sex, body mass index, kidney function and medication use, increased levels of NT-proBNP (per 1 unit natural log-transformed values, odds ratio (OR) = 5.55; 95CI%:1.65–18.72) and Hs-cTnT (per 1 unit natural log-transformed values, OR = 7.11; 95CI%:1.41–35.90) showed significant association with the severity of CCM per 1 unit increase of biomarkers. The accuracy of NT-proBNP and Hs-cTnT for diagnosis of the severity of CCM was high: AUC of 0.968 and 0.956 respectively. No significant difference was found in the AUC between NT-proBNP and Hs-cTnT. No association was found between Gal-3, NGAL, sST2 and Cys-C and severity of CCM.ConclusionsNT-proBNP and Hs-cTnT have both same diagnostic value in distinguishing severity of CCM.