Abstract：
BACKGROUND: Transposition of the great arteries (TGA) is a cyanotic congenital heart defect for which the arterial switch operation (ASO) is the preferred surgical repair. This study wanted to investigate whether a panel of biomarkers could identify morphologic as well as hemodynamic changes obtained by cardiac magnetic resonance (CMR).
METHODS: Forty-four adult patients were included. Blood samples were collected to measure a broad range of biomarkers (galectin-3, ST2, GDF-15, PINP, ICTP, PIIINP, IGF-1, NT-proBNP, and hs-Tn). CMR was performed at rest and during exercise to assess cardiac function and morphology. Explorative statistics were performed between biomarker levels and CMR findings.
RESULTS: All patients were asymptomatic. While galectin-3, GDF-15, and NT-proBNP levels were within normal ranges, increased ST2, PINP, PIIINP, and ICTP levels were found in 20.5%, 34.1%, 45.5%, and 27.3% of patients, respectively. Moreover, 3 and 2 patients, respectively, showed elevated IGF-1 and hs-Tn levels. Although the ejection fraction of both ventricles was within normal limits, impaired cardiac reserve was found in 20 and 25% of patients for left and right ventricle, respectively. CMR revealed no evidence of diffuse interstitial fibrosis, while 4 patients showed focal ischemic scarring. However, no significant associations between serum biomarkers and CMR data could be detected.
CONCLUSIONS: The results suggest that in asymptomatic ASO-repaired TGA patients serum level biomarkers are elevated and that this increase is not associated with morphological changes nor with a decreased cardiac reserve. Further study with larger sample sizes is required to draw conclusions with greater confidence.
METHODS: Forty-four adult patients were included. Blood samples were collected to measure a broad range of biomarkers (galectin-3, ST2, GDF-15, PINP, ICTP, PIIINP, IGF-1, NT-proBNP, and hs-Tn). CMR was performed at rest and during exercise to assess cardiac function and morphology. Explorative statistics were performed between biomarker levels and CMR findings.
RESULTS: All patients were asymptomatic. While galectin-3, GDF-15, and NT-proBNP levels were within normal ranges, increased ST2, PINP, PIIINP, and ICTP levels were found in 20.5%, 34.1%, 45.5%, and 27.3% of patients, respectively. Moreover, 3 and 2 patients, respectively, showed elevated IGF-1 and hs-Tn levels. Although the ejection fraction of both ventricles was within normal limits, impaired cardiac reserve was found in 20 and 25% of patients for left and right ventricle, respectively. CMR revealed no evidence of diffuse interstitial fibrosis, while 4 patients showed focal ischemic scarring. However, no significant associations between serum biomarkers and CMR data could be detected.
CONCLUSIONS: The results suggest that in asymptomatic ASO-repaired TGA patients serum level biomarkers are elevated and that this increase is not associated with morphological changes nor with a decreased cardiac reserve. Further study with larger sample sizes is required to draw conclusions with greater confidence.
摘要：
背景：大动脉转位（TGA）是一种紫红色先天性心脏缺损，动脉转换手术（ASO）是首选的手术修复方法。这项研究旨在研究一组生物标志物是否可以识别通过心脏磁共振（CMR）获得的形态学和血液动力学变化。
方法：纳入44例成人患者。收集血液样本以测量广泛的生物标志物(半乳糖凝集素-3、ST2、GDF-15、PINP、ICTP,PIIINP,IGF-1,NT-proBNP,和hs-Tn）。在休息和运动期间进行CMR以评估心脏功能和形态。在生物标志物水平和CMR发现之间进行了探索性统计。
结果：所有患者均无症状。虽然半乳糖凝集素-3，GDF-15和NT-proBNP水平在正常范围内，增加ST2，PINP，PIIINP,ICTP水平为20.5%，34.1%,45.5%,27.3%的病人,分别。此外，3和2名患者，分别,显示IGF-1和hs-Tn水平升高。虽然两个心室的射血分数在正常范围内，在20％和25％的左右心室患者中发现心脏储备受损，分别。CMR显示没有弥漫性间质纤维化的证据，4例患者出现局灶性缺血性瘢痕。然而,未检测到血清生物标志物和CMR数据之间的显著关联.
结论：结果表明，在无症状的ASO修复的TGA患者中，血清生物标志物水平升高，并且这种升高与形态学改变或心脏储备降低无关。需要进行更大样本量的进一步研究，以更有信心地得出结论。
方法：纳入44例成人患者。收集血液样本以测量广泛的生物标志物(半乳糖凝集素-3、ST2、GDF-15、PINP、ICTP,PIIINP,IGF-1,NT-proBNP,和hs-Tn）。在休息和运动期间进行CMR以评估心脏功能和形态。在生物标志物水平和CMR发现之间进行了探索性统计。
结果：所有患者均无症状。虽然半乳糖凝集素-3，GDF-15和NT-proBNP水平在正常范围内，增加ST2，PINP，PIIINP,ICTP水平为20.5%，34.1%,45.5%,27.3%的病人,分别。此外，3和2名患者，分别,显示IGF-1和hs-Tn水平升高。虽然两个心室的射血分数在正常范围内，在20％和25％的左右心室患者中发现心脏储备受损，分别。CMR显示没有弥漫性间质纤维化的证据，4例患者出现局灶性缺血性瘢痕。然而,未检测到血清生物标志物和CMR数据之间的显著关联.
结论：结果表明，在无症状的ASO修复的TGA患者中，血清生物标志物水平升高，并且这种升高与形态学改变或心脏储备降低无关。需要进行更大样本量的进一步研究，以更有信心地得出结论。
