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Plasma big endothelin-1 is an effective predictor for ventricular arrythmias and end-stage events in primary prevention implantable cardioverter-defibrillator indication patients

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Journal of Geriatric Cardiology 2020年第7期17卷 427-433页

作者： Xiao-Yao LI Shuang ZHAO Xiao-Han FAN Ke-Ping CHEN Wei HUA Zhi-Min LIU Xiao-Di XUE Bin ZHOU Shu ZHANG Arrhythmia Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods In total, 207 patients fulfilling the inclusion criteria from Fuwai Hospital between January 2013 and December 2015 were retrospectively analyzed. The cohort was divided into three groups according to baseline plasma big ET-1 tertiles: tertile 1( 0.7 pmol/L, n = 70). The primary endpoints were VAs. The secondary endpoints were end-stage events comprising all-cause mortality and heart transplantation. Results During a mean follow-up period of 25.6 ± 13.9 months, 38(18.4%) VAs and 78(37.7%) end-stage events occurred. Big ET-1 was positively correlated with NYHA class(r = 0.165, P = 0.018), serum creatinine concentration(Scr;r = 0.147, P = 0.034), high-sensitivity C-reactive protein(hs-CRP;r = 0.217, P = 0.002), Lg NT-pro BNP(r = 0.463, P end diastolic diameter(LVEDD;r = 0.234, P = 0.039) and negatively correlated with left ventricular ejection fraction(LVEF;r =-0.181, P = 0.032). Kaplan-Meier analysis showed that elevated big ET-1 was associated with increased risk of VAs and end-stage events(P endent risk factor for VAs(hazard ratio(HR) = 3.477, 95% confidence interval(CI): 1.352–8.940, P = 0.010, tertile 2 vs. tertile 1;HR = 4.112, 95% CI: 1.604–10.540, P = 0.003, tertile 3 vs. tertile 1) and end-stage events(HR = 2.804, 95% CI: 1.354–5.806, P = 0.005, tertile 2 vs. tertile 1;HR = 4.652, 95% CI: 2.288–9.459, P end-stage events and may facilitate ICD-implantation risk stratification.

关键词： Big endothelin-1 end-stage events Implantable cardioverter-defibrillator implantation Primary prevention Ventricular arrythmias

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