Value of soluble Urokinase plasminogen activator receptor over age as a biomarker of impaired myocardial relaxation

可溶性尿激酶型纤溶酶原激活剂受体作为心肌舒张功能受损生物标志物的价值随年龄增长而变化

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作者:Angela S Koh, Bhaarathy Velmurugan, Fei Gao, Ru San Tan, Jia-Ing Wong, Louis L Y Teo, Bryan M H Keng, Serene J M Chua, Jian-Min Yuan, Woon-Puay Koh, Christine Cheung

Background

SuPAR is a biomarker that reflects the level of immune activation. As inflammation plays an important role in the ageing process of the cardiovascular system, we hypothesized that suPAR might be a useful predictive biomarker of the ageing heart.

Conclusion

We demonstrate additional ability of suPAR, over age, to predict impaired myocardial relaxation.

Methods

We performed conventional and tissue Doppler echocardiography and measured plasma suPAR levels.

Results

We studied community adults (n=120, 37.5% female) (mean age: 70.3±9.3 years) without known cardiovascular disease (CVD). Participants with impaired myocardial relaxation were older (84% vs 59% were aged ≥71 years, p=0.002), with more diabetes mellitus (27% vs 11%, p=0.034). SuPAR levels were higher among participants with impaired myocardial relaxation (3.9 ng/ml vs 3.0 ng/ml, p=0.015). At the univariate level, older age (OR 3.6; 95%CI 1.6, 8.5; p=0.003), diabetes mellitus (OR 3.04; 95%CI 1.1, 8.8; p=0.04), systolic blood pressure (OR 1.03; 95%CI 1.001, 1.1; p=0.041) and suPAR levels ≥3.00ng/ml (OR 3.4; 95%CI 1.16, 7.4; p=0.002) were associated with impaired myocardial relaxation. In multivariable regression analysis, only older age (OR 2.8; 95%CI 1.1, 6.7; p=0.026) and suPAR (OR 2.7; 95%CI 1.2, 6.1; p=0.018) remained independently associated with impaired myocardial relaxation. Receiver operating characteristics (ROC) curve analysis revealed an area under the curve (AUC) value of 0.63 (95% CI 0.54, 0.71) for model that included age alone. Addition of suPAR significantly increased AUC value to 0.70 (95%CI 0.60, 0.79), which was significantly larger than the model with age alone (p=0.016).

Trial registration

ClinicalTrials.gov Identifier: NCT02791139 (Registered May 31, 2016).

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