Aim: This study assessed the utility of SPARC-like protein 1 (SPARCL1) as a biomarker of maladaptive right ventricular (RV) function in patients with pulmonary hypertension (PH).Methods: In this prospective study, we examined SPARCL1 levels in 105 patients with adaptive (n = 34) and maladaptive RV (n = 32) pressure overload caused by PH, dilated cardiomyopathy (DCM, n = 18) with LVEF < 35% and preserved RV function and controls without LV or RV abnormalities (n = 21).Results: The median SPARCL1 concentration in patients with maladaptive RV function was higher than in those with adaptive RV function (p < 0.01), DCM (p < 0.001) or controls (p < 0.001). Patients with adaptive RV function had higher SPARCL1 concentrations than controls (p < 0.05), whereas there was no difference between adaptive RV and DCM. SPARCL1 showed good predictive power for maladaptive RV (AUC 0.77, p < 0.001) with an optimal cut-off value of 9.66 ng/ml. The TAPSE/PASP ratio was the only independent predictor of SPARCL1 ≥ 9.66 ng/ml in multivariable logistic regression analysis.Conclusion: SPARCL1 shows potential as novel biomarker of RV pathological remodelling and is associated with RV maladaptation and ventriculoarterial uncoupling in PH.

中文翻译：

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SPARCL1作为肺动脉高压适应不良的右心室重构的生物标志物。

目的：本研究评估了SPARC样蛋白1（SPARCL1）作为肺动脉高压（PH）患者适应不良的右心室（RV）功能的生物标志物的方法。方法：在这项前瞻性研究中，我们检查了105例患者的SPARCL1水平具有由PH引起的适应性（n = 34）和适应不良的RV（n = 32），LVEF <35％的扩张型心肌病（DCM，n = 18），RV功能得以保留以及无LV或RV异常的对照组（n = 21）结果：适应不良性RV功能患者的SPARCL1浓度中位数高于适应性RV功能患者（p <0.01），DCM（p <0.001）或对照组（p <0.001）。具有适应性RV功能的患者的SPARCL1浓度高于对照组（p <0.05），而适应性RV和DCM之间没有差异。SPARCL1对适应不良的RV表现出良好的预测能力（AUC 0.77，p <0.001），最佳临界值为9.66 ng / ml。TAPSE / PASP比值是多变量Logistic回归分析中SPARCL1≥9.66 ng / ml的唯一独立预测因子。结论：SPARCL1具有潜在的RV病理重塑的新生物标志物，与RV适应不良和PH的心室动脉解偶联有关。