Abstract：
OBJECTIVE: Myocardial infarction is associated with right ventricular (RV) remodeling. Glypican-6 (GPC6), a member of the membrane proteoglycan family, plays a significant role in cardiac remodeling. This study aims to determine if GPC6 can predict RV remodeling after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation myocardial infarction (NSTEMI).
METHODS: The study enrolled 164 consecutive patients with NSTEMI and controls. It compared baseline plasma GPC6 levels, echocardiography, and laboratory parameters between the RV remodeling and non-RV remodeling groups with NSTEMI. Echocardiographic data were measured at baseline and at six months.
RESULTS: GPC6 levels were higher in the NSTEMI group 11.06 ng/mL (4.61-18.17) vs. 5.98 ng/mL (3.81-9.83) compared to the control group in the initial phase. RV remodeling, defined as a ≥ 20% increase in RV end-diastolic area (RV EDA), was observed in 23 patients (30%). After six months, RV EDA increased significantly from baseline 18.68 ± 1.20 cm2 vs. 24.91 ± 1.08 cm2, P < 0.001. GPC6 was a significant independent predictor of RV remodeling (hazard ratio [HR]: 1.546, 95% confidence interval [CI]: 1.056-2.245, P < 0.001). Receiver operating characteristic curve (ROC) analyses showed that GPC6 values > 15.5 ng/mL (area under the curve [AUC] = 0.828, sensitivity: 70%, specificity: 74%, P < 0.001) were strong predictors of RV remodeling.
CONCLUSIONS: NSTEMI patients should be closely monitored for RV remodeling. GPC6 appears useful in detecting RV remodeling following NSTEMI in patients undergoing PCI.
METHODS: The study enrolled 164 consecutive patients with NSTEMI and controls. It compared baseline plasma GPC6 levels, echocardiography, and laboratory parameters between the RV remodeling and non-RV remodeling groups with NSTEMI. Echocardiographic data were measured at baseline and at six months.
RESULTS: GPC6 levels were higher in the NSTEMI group 11.06 ng/mL (4.61-18.17) vs. 5.98 ng/mL (3.81-9.83) compared to the control group in the initial phase. RV remodeling, defined as a ≥ 20% increase in RV end-diastolic area (RV EDA), was observed in 23 patients (30%). After six months, RV EDA increased significantly from baseline 18.68 ± 1.20 cm2 vs. 24.91 ± 1.08 cm2, P < 0.001. GPC6 was a significant independent predictor of RV remodeling (hazard ratio [HR]: 1.546, 95% confidence interval [CI]: 1.056-2.245, P < 0.001). Receiver operating characteristic curve (ROC) analyses showed that GPC6 values > 15.5 ng/mL (area under the curve [AUC] = 0.828, sensitivity: 70%, specificity: 74%, P < 0.001) were strong predictors of RV remodeling.
CONCLUSIONS: NSTEMI patients should be closely monitored for RV remodeling. GPC6 appears useful in detecting RV remodeling following NSTEMI in patients undergoing PCI.
摘要：
目的：心肌梗死与右心室重构有关。Glypican-6(GPC6),膜蛋白多糖家族的一员,在心脏重构中起着重要作用。这项研究旨在确定GPC6是否可以预测非ST段抬高型心肌梗死（NSTEMI）患者经皮冠状动脉介入治疗（PCI）后的RV重塑。
方法：本研究连续纳入164例NSTEMI患者和对照组。它比较了基线血浆GPC6水平，超声心动图,以及具有NSTEMI的RV重塑和非RV重塑组之间的实验室参数。在基线和6个月时测量超声心动图数据。
结果：NSTEMI组的GPC6水平高于11.06ng/mL（4.61-18.17）。与初始阶段的对照组相比，为5.98ng/mL（3.81-9.83）。房车改造,定义为右心室舒张末期面积(RVEDA)增加≥20%，在23例患者中观察到（30％）。六个月后,RVEDA从基线显著增加18.68±1.20cm2与24.91±1.08cm2,P<0.001。GPC6是RV重塑的显著独立预测因子(风险比[HR]:1.546,95%置信区间[CI]:1.056-2.245,P<0.001)。受试者工作特征曲线（ROC）分析表明，GPC6值>15.5ng/mL（曲线下面积[AUC]=0.828，灵敏度：70％，特异性：74%，P<0.001)是RV重塑的强预测因子。
结论：NSTEMI患者应密切监测RV重塑。GPC6似乎可用于检测PCI患者NSTEMI后的RV重塑。
方法：本研究连续纳入164例NSTEMI患者和对照组。它比较了基线血浆GPC6水平，超声心动图,以及具有NSTEMI的RV重塑和非RV重塑组之间的实验室参数。在基线和6个月时测量超声心动图数据。
结果：NSTEMI组的GPC6水平高于11.06ng/mL（4.61-18.17）。与初始阶段的对照组相比，为5.98ng/mL（3.81-9.83）。房车改造,定义为右心室舒张末期面积(RVEDA)增加≥20%，在23例患者中观察到（30％）。六个月后,RVEDA从基线显著增加18.68±1.20cm2与24.91±1.08cm2,P<0.001。GPC6是RV重塑的显著独立预测因子(风险比[HR]:1.546,95%置信区间[CI]:1.056-2.245,P<0.001)。受试者工作特征曲线（ROC）分析表明，GPC6值>15.5ng/mL（曲线下面积[AUC]=0.828，灵敏度：70％，特异性：74%，P<0.001)是RV重塑的强预测因子。
结论：NSTEMI患者应密切监测RV重塑。GPC6似乎可用于检测PCI患者NSTEMI后的RV重塑。
