Pulmoner hipertansiyonlu hastalarda serum NT-proBNP ve SST2 düzeylerinin prognostik değeri
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Date
2019
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İnönü Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Giriş ve Amaç: sST2'nin kardiyak fibrozisi gösteren bir belirteç olması nedeniyle çocuklarda sağ kalp yetersizliği ve mortalitenin önemli bir göstergesi olduğu ve PHT için biyobelirteç olabileceği ileri sürülmüştür. Çalışmamızda PHT tanılı çocuk hastaların serum sST2 düzeyleri incelenerek PHT tanı ve prognozunda kullanılabilirliğinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışma Kasım 2018-Ekim 2019 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Kardiyolojisi Bilim dalında gerçekleştirildi. PHT ile takipli 23 hasta ile polikliniğe üfürüm, göğüs ağrısı gibi şikâyetlerle başvuran; fizik muayene bulguları, elektrokardiyogram ve ekokardiyogram bulguları normal olarak değerlendirilen 30 sağlıklı çocuk çalışmaya dâhil edildi. Hasta ve kontrol grubu olgularından rutin poliklinik kontrolleri esnasında sST2 ve NT-proBNP düzeyleri için biyokimya tüplerine 3 mililitre kan örneği alındı ve 3000 devirde 10 dakika santrifüj edildi. Biotec marka sinergy H1 model biyokimya otoanalizöründe immunotürbidimetrik yöntemle; NT-proBNP, Siemens immulate-2000 model cihazda kemilüminesans yöntemle; sST2 düzeyleri "Human sICAM-1 Elisa Kit RayBıotech Inc. USA" kiti kullanılarak ELISA yöntemiyle çalışıldı. Sonuçlar pg/mL olarak ifade edildi. Bulgular: Hasta grubunun yaş ortalaması 13.9 yıl (5.5-18), kontrol grubunun yaş ortalaması 9.6 yıl (3-17) idi. Serum sST2 düzeyleri hasta grubunda 1469.26±510.9 pg/mL iken kontrol grubunda 1151.30±655.99 pg/mL tespit edildi. Hasta ve kontrol grubu sST2 düzeyleri arasında istatistiksel olarak anlamlı bir fark bulunmadı (p:0.057). Serum NT-proBNP düzeyleri hasta grubunda 763.73±2432.67 pg/mL iken kontrol grubunda 51.71±30.08 pg/mL tespit edildi. Hasta grubunda kontrol grubuna göre NT-proBNP düzeyleri istatistiksel olarak anlamlı derecede yüksek tespit edildi (p<0.01). Sonuçlar: Çalışmamızda diğer çalışmalara paralel olarak NT-proBNP düzeyleri hasta grubunda anlamlı olarak yüksek bulunmuştur. Önceki çalışmalarda sST2'nin PHT'li hastalarda biyobelirteç olarak kullanımı ile ilgili olumlu sonuçlar elde edimesine rağmen çalışmamızda sST2'nin PHT'li hastalarda biyobelirteç olarak kullanımının güvenilir olmadığını tespit ettik. Bu konu ile ilgili çalışmalar sınırlı olması nedeniyle sST2'nin PHT'li hastalarda biyobelirteç olarak kullanımı açısından değerlendirilmesi için daha geniş hasta serisi ile daha fazla çalışmaya ihtiyaç vardır. Anahtar Kelimeler: PHT, NT-proBNP, sST2, prognoz
Prognostic Value of Serum NT-proBNP and sST2 Levels in Patients with Pulmonary Hypertension Aim: sST2 is an indicator of cardiac fibrosis, it has been suggested that it is an important indicator of right heart failure and mortality in children and may be a novel biomarker for prognostic indicator in children with PHT. Aim of ths study is serum sST2 levels and NT-proBNP levels were evaluated in pediatric patients with PHT and investigated for its utility as a biomarker in the diagnosis and prognosis of pulmonary hypertension. Materials and Method: The study was conducted between November 2018 and October 2019 in the Department of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Inönü University. 23 patients followed with PHT and 30 healthy childrens were evaluated in pediatric cardiology clinic due to different complaints such as murmur and chest pain; All patients and control group were evaluated with electrocardiography, and echocardiography after physical examination. For sST2 and NT-proBNP levels, 3 milliliters of blood samples were taken into biochemistry tubes and centrifuged at 3000 rpm for 10 minutes. Biotec brand sinergy H1 model biochemistry autoanalyser by immunoturbidimetric method; NT-proBNP, Siemens immulate-2000 model device by chemiluminescence method; Soluble-ST2 levels "Human sICAM-1 Elisa Kit RayBiotech Inc. USA" kit and ELISA method. The results were expressed in pg/mL. Results: The mean age of the patient group was 13.9 (5.5-18), years and the mean age of the control group was 9.6 years (3-17). Serum sST2 levels were 1469.26±510.9 pg/mL in the patient group and 1151.30±655.99 pg/mL in the control group. There was no statistically significant difference between sST2 levels in the patient group compared to the control group (p: 0.057). Serum NT-proBNP levels were 763.73±2432.67 pg/mL in the patient group and 51.71±30.08 pg/mL in the control group. NT-proBNP levels were significantly higher in the patient group compared to the control group (p <0.01). Conclusion: In this study, NT-proBNP levels were found to be significantly higher in the patient group in parallel with previous studies. Although previous studies conducted in literature showed positive results regarding the use of sST2 as a biomarker in patients with PHT, we found that the use of sST2 as a biomarker in patients with PHT was not reliable. As studies on this subject are limited, further studies with larger patient series are needed to evaluate sST2 as a biomarker in PHT patients. Keywords: PHT, NT-proBNP, sST2, prognosis
Prognostic Value of Serum NT-proBNP and sST2 Levels in Patients with Pulmonary Hypertension Aim: sST2 is an indicator of cardiac fibrosis, it has been suggested that it is an important indicator of right heart failure and mortality in children and may be a novel biomarker for prognostic indicator in children with PHT. Aim of ths study is serum sST2 levels and NT-proBNP levels were evaluated in pediatric patients with PHT and investigated for its utility as a biomarker in the diagnosis and prognosis of pulmonary hypertension. Materials and Method: The study was conducted between November 2018 and October 2019 in the Department of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Inönü University. 23 patients followed with PHT and 30 healthy childrens were evaluated in pediatric cardiology clinic due to different complaints such as murmur and chest pain; All patients and control group were evaluated with electrocardiography, and echocardiography after physical examination. For sST2 and NT-proBNP levels, 3 milliliters of blood samples were taken into biochemistry tubes and centrifuged at 3000 rpm for 10 minutes. Biotec brand sinergy H1 model biochemistry autoanalyser by immunoturbidimetric method; NT-proBNP, Siemens immulate-2000 model device by chemiluminescence method; Soluble-ST2 levels "Human sICAM-1 Elisa Kit RayBiotech Inc. USA" kit and ELISA method. The results were expressed in pg/mL. Results: The mean age of the patient group was 13.9 (5.5-18), years and the mean age of the control group was 9.6 years (3-17). Serum sST2 levels were 1469.26±510.9 pg/mL in the patient group and 1151.30±655.99 pg/mL in the control group. There was no statistically significant difference between sST2 levels in the patient group compared to the control group (p: 0.057). Serum NT-proBNP levels were 763.73±2432.67 pg/mL in the patient group and 51.71±30.08 pg/mL in the control group. NT-proBNP levels were significantly higher in the patient group compared to the control group (p <0.01). Conclusion: In this study, NT-proBNP levels were found to be significantly higher in the patient group in parallel with previous studies. Although previous studies conducted in literature showed positive results regarding the use of sST2 as a biomarker in patients with PHT, we found that the use of sST2 as a biomarker in patients with PHT was not reliable. As studies on this subject are limited, further studies with larger patient series are needed to evaluate sST2 as a biomarker in PHT patients. Keywords: PHT, NT-proBNP, sST2, prognosis
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Keywords
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
