Clinical Significance of Apela in Acute Cardiorenal Insuffiency of Chronic Heart Failure.

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2024-01-18 DOI:10.1159/000536316

Yani Zong, Yajie Wang, Yuexin Hu, Zhi Wang

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Abstract

Introduction: Apela has a wide range of biological effects on the cardiovascular system, but the changes and significance of endogenous Apela in patients with chronic heart failure (CHF) and acute deterioration of cardiac and renal function are unclear.

Methods: A total of 69 patients with stable CHF combined with well-preserved renal function were enrolled and followed for 12 months. The effects of Apela on human renal glomerular endothelial cells (hRGEC), human glomerular mesangial cells (hMC), and human renal tubular epithelial cells (HK-2) were observed.

Results: Serum Apela concentration was positively correlated with NYHA class (r = 0.711) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration (r = 0.303) but negatively correlated with left ventricular ejection fraction (LVEF) (r = -0.374) and 6-min walk distance (r = -0.860) in patients with stable CHF. Twenty-one patients experiencing deterioration of renal and cardiac function were diagnosed with cardiorenal syndrome (CRS) during the follow-up period. In addition, the serum Apela, as well as the difference in Apela between stable and worsening phases (ΔApela), was correlated with the estimated glomerular filtration rate (eGFR) and ΔeGFR in patients with CRS. Apela significantly inhibited the upregulated expression of MCP-1 and TNF-α induced by angiotensin II (AngII) in hRGEC, hMC, and HK-2 cells. Apela inhibited the adhesion of THP-1 cells to hRGEC and promoted the tubular formation of hRGEC. Moreover, Apela enhanced the expression of MMP-9 in hMC but inhibited the upregulated expression of α-SMA and vimentin in HK-2 cells by AngII.

Conclusion: This study suggests that the level of Apela can be used to diagnose heart failure and assess the severity of cardiac dysfunction in patients with stable CHF, and its dynamic changes can be used to evaluate the damage to renal function in patients with CRS. Apela plays multiple protective effects on renal cells, highlighting its clinical application prospect in the prevention and treatment of CRS.

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阿佩拉对慢性心力衰竭急性心肾功能不全的临床意义。

导言：Apela对心血管系统具有广泛的生物学效应，但慢性心力衰竭（CHF）和心肾功能急性恶化患者内源性Apela的变化和意义尚不清楚：方法：共招募了 69 名病情稳定且肾功能保持良好的 CHF 患者，并对其进行了为期 12 个月的随访。观察阿培拉对人肾小球内皮细胞（hRGEC）、人肾小球系膜细胞（hGMC）和人肾小管上皮细胞（HK-2）的影响：结果：在病情稳定的 CHF 患者中，血清 Apela 浓度与 NYHA 分级（r = 0.711）和 N 端前脑钠尿肽（NT-proBNP）浓度（r = 0.303）呈正相关，但与左室射血分数（LVEF）（r = -0.374）和 6 分钟步行距离（r = -0.860）呈负相关。在随访期间，21 名肾功能和心功能恶化的患者被诊断为心肾综合征（CRS）。此外，CRS患者的血清Apela以及稳定期和恶化期的Apela差值（ΔApela）与估计肾小球滤过率（eGFR）和ΔeGFR相关。Apela能明显抑制血管紧张素II（AngII）诱导的MCP-1和TNF-α在hRGEC、hGMC和HK-2细胞中的上调表达。Apela 可抑制 THP-1 细胞与 hRGEC 的粘附，并促进 hRGEC 小管的形成。此外，Apela 能增强 hGMC 中 MMP-9 的表达，但抑制了 AngII 对 HK-2 细胞中 α-SMA 和波形蛋白表达的上调：本研究表明，Apela水平可用于诊断心衰和评估稳定型CHF患者心功能不全的严重程度，其动态变化可用于评估CRS患者肾功能的损伤。Apela对肾脏细胞具有多重保护作用，在预防和治疗CRS方面具有广阔的临床应用前景。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.