Alexander E BEREZİN, Alexander A KREMZER

Kronik kalp yetmezliği bulunan hastalarda serum ürik asit düzeyi ile proanjiojenik mononükleer projenitör hücre konsantrasyonu arasındaki ilişki

Objective: Serum uric acid (UA) is considered as a marker of natural progression of chronic heart failure (CHF). Progression of CHF associates with declining of circulating mononuclear progenitor cells (MPCs) in the blood. The objective of this study was to evaluate the interrelationship between SUA concentrations and proangiogenic MPCs in ischemic CHF patients.Methods: The study was structured retrospectively after determining the coronary artery disease (CAD) by contrast-enhanced spiral computed tomography angiography in 126 subjects (54 male), aged 48 to 62 years, with CHF. Serum UA level was measured by enzymatic method and N-terminal proBNP (NT-pro-BNP) level was examined by immunoelectrochemiluminesence method. All biomarkers were measured at baseline.Results: Concentrations of SUA were distributed by quartiles (Me; IQR): QI=20.11 (19.06; 22.33) mmol/l; QII=27.53 (23.2; 31.10) mmol/l; QIII=35.80 (32.0; 39.0) mmol/l; and QIV=44.9 (40.00; 49.60) mmol/l. Cox proportional adjusted Odds Ratios analyses for CD14+CD309+ and CD14+CD309+Tie2+ MPCs by SUA Quartiles (Q) has showed that high Q (Q3 and Q4) of SUA versus low Q (Q1 and Q2) associated with increased risk of depletion of both CD14+CD309+ and CD14+CD309+Tie2+ MPCs. The ROC analysis has been showed that there was the cut-off point for the SUA level with the best prognostic potential on the risk of decreasing MPCs in both models equal 31.5 mmol/l.Conclusion: Circulated level of proangiogenic MPCs is declined progressively depended on quartiles of serum UA level in CHF subjects. We suggest that mild elevation of serum UA might be considered as a predictor of low proangiogenic MPCs in CHF patients.

The relationship between serum uric acid level and concentration of proangiogenic mononuclear progenitor cells in patients with chronic heart failure

Amaç: Serum ürik asit (ÜA) kronik kap yetmezliğinin (KKY) doğal ilerleyişinin bir belirteci olarak bilinir. KKY ilerlemesi kanda dolaşan mononükleer projenitör hücrelerin (MPH) azalması ile birliktedir. Bu çalışmanın amacı iskemik KKY'li hasatlarda serum ÜA ve proanjiyojenik MPH konsantrasyonları arasındaki ilişkiyi değerlendirmektir. Yöntemler: Bu çalışma kontrastlı bilgisayarlı tomografi anjiyografisi ile koroner arter hastalığı (KAH) tanısı alan KKY'li 126 hastada (54 erkek)retrospektif olarak yapılmıştır. Serum ÜA enzimatik yöntemle ve N-terminal proBNP (NT-pro-BNP) düzeyi immünoelektrokemilüminesens yöntemi ile çalışıldı.Bulgular: Serum ÜA konsantrasyonları kuartallar olarak değerlendirildi (Me; IQR): QI=20.11 (19.06; 22.33) mmol/l; QII=27.53 (23.2; 31.10) mmol/l; QIII=35.80 (32.0; 39.0) mmol/l ve QIV=44.9 (40.00; 49.60) mmol/l. Serum ÜA'e göre düzeltilmiş Cox oransal Odds oranı analizleri CD14+CD309+ ve CD14+CD309+Tie2+ MPH için SUA Quartiles (Q) ile yapıldı ve Yüksek serum ÜA Q (Q3 ve Q4) ve düşük Q (Q1 ve Q2)'nin artmış CD14+CD309+ ve CD14+CD309+Tie2+ MPH tükenme riski ile birlikte olduğu gösterildi. ROC analizi ile serum ÜA 31,5 mmol/l değeri MPH azalma riski için en iyi potansiyel cut-off değeri olarak belirlendi.Sonuç: Konjestif kalp yetmezliği bulunan hastalarda dolaşan proanjiyojenik MPH, serum ÜA kuartallarına bağlı olarak ilerleyici bir şekilde azaldı. Serum ÜA'de hafif artışın düşük proanjiyojenik MPH'nin bir öngördürücüsü olarak kabul edilebilir.

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