RESUMO
BACKGROUND: Connective tissue growth factor (CTGF) has been recently reported as a mediator of myocardial fibrosis; however, the significance of plasma CTGF concentration has not been evaluated in patients with heart failure. The aim of this study was to investigate the clinical utility of plasma CTGF concentration for the diagnosis of heart failure. METHODS AND RESULTS: We evaluated fifty-two patients with chronic heart failure. The plasma concentration of CTGF and other markers of fibrosis were assessed and compared with clinical and echocardiographic data. Plasma CTGF was significantly elevated in symptomatic patients in proportion to their NYHA classes and was significantly correlated with plasma brain natriuretic peptide (BNP) concentration (r=0.395, P<0.01). Plasma CTGF was also correlated with plasma transforming growth factor beta (TGF-beta) (r=0.512, P<0.01), matrix metalloproteinase (MMP)-2 (r=0.391, P<0.05) and tissue inhibitor of MMP (TIMP)-2 (r=0.354, P<0.05) concentrations. Interestingly, plasma CTGF was correlated with E/E' value evaluated by tissue Doppler echocardiography (r=0.593, P=0.012), but not with systolic function and left ventricular mass. CONCLUSION: Our study suggests that plasma CTGF concentration is a novel diagnostic marker for cardiac dysfunction and may provide additional specific information about myocardial fibrosis in chronic heart failure patients.
Assuntos
Insuficiência Cardíaca/diagnóstico , Proteínas Imediatamente Precoces/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Fator de Crescimento do Tecido Conjuntivo , Ecocardiografia Doppler , Proteínas da Matriz Extracelular/sangue , Feminino , Insuficiência Cardíaca/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Norepinefrina/sangue , Valor Preditivo dos Testes , Estatística como Assunto , Fator de Crescimento Transformador beta/sangue , Remodelação Ventricular/fisiologiaRESUMO
Nestin is a type of intermediate filament abundantly expressed in neuroepithelial stem cells or mesenchymal stem cells. We assessed directional coronary atherectomy specimens from primary and restenotic lesions for expression of nestin. Immunohistochemistry showed predominant expression of nestin in stellate smooth muscle cells (SMCs). Given that nestin has been proposed to be a marker for putative stem cells, our results suggest that human coronary plaques contain cells that have the potential for multiple lineages. Although the role of nestin remains unclear, nestin-positive stellate SMCs are more frequently seen in patients with unstable angina.