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Otaki Y, Shimizu M, Watanabe T, Tachibana S, Sato J, Kobayashi Y, Aono T, Kato S, Tamura H, Nishiyama S, Arimoto T, Takahashi H, Watanabe M. Growth Differentiation Factor 15 and Clinical Outcomes in Japanese Patients With Heart Failure. Circ J 2023; 87:1120-1129. [PMID: 36948614 DOI: 10.1253/circj.cj-23-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Heart failure (HF) is an increasing health problem associated with a high mortality rate. Growth differentiation factor (GDF) 15, a stress response cytokine belonging to the transforming growth factor-β superfamily, is associated with poor clinical outcomes in a broad spectrum of cardiovascular diseases. However, the prognostic usefulness of GDF15 in Japanese patients with HF remains unclear. METHODS AND RESULTS We measured serum concentrations of GDF15 and B-type natriuretic peptide (BNP) in 1,201 patients with HF. All patients were prospectively followed for a median period of 1,309 days. In all, 319 HF-related events and 187 all-cause deaths occurred during the follow-up period. Kaplan-Meier analysis demonstrated that, among GDF15 tertiles, the highest tertile group had the greatest risk of HF-related events and all-cause mortality. Multivariate Cox proportional hazard regression analysis demonstrated that the serum GDF15 concentration was an independent predictor of HF-related events and all-cause deaths after adjusting for confounding risk factors. Serum GDF15 improved the prediction capacity for all-cause deaths and HF-related events with a significant net reclassification index and integrated discrimination improvement. Subgroup analysis in patients with HF with preserved ejection fraction also showed the prognostic usefulness of GDF15. CONCLUSIONS Serum GDF15 concentrations were associated with HF severity and clinical outcomes, indicating that GDF15 could provide additional clinical information to track the health status of patients with HF.
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Affiliation(s)
- Yoichiro Otaki
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Mari Shimizu
- Faculty of Medicine, Yamagata University School of Medicine
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Shingo Tachibana
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Junya Sato
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Yuta Kobayashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Tomonori Aono
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Shigehiko Kato
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Harutoshi Tamura
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Satoshi Nishiyama
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Takanori Arimoto
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Hiroki Takahashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
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2
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Marschall A, Del Castillo Carnevali H, Fernández Pascual C, Lorente Rubio A, Morales Gallardo MJ, Dejuán Bitriá C, Delgado Calva FA, Duarte Torres J, Biscotti Rodil B, Rodriguez Torres D, Álvarez Antón S, Martí Sánchez D. Incidence and Predictors of Progression in Asymptomatic Patients With Stable Heart Failure. Am J Cardiol 2021; 152:88-93. [PMID: 34147209 DOI: 10.1016/j.amjcard.2021.04.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/15/2022]
Abstract
Data from previous heart failure (HF) trials suggest that patients with mild symptoms (NYHA II) actually have a poor clinical outcome. However, these studies did not assess clinical stability and rarely included patients in NYHA I. We sought to determine the incidence of short-term clinical progression in supposedly stable HF patients in NYHA I. In addition, we aimed to investigate the predictive value of widely available electrocardiographic and echocardiographic parameters for short-term disease progression. This is a retrospective study including 153 consecutive patients with HF with reduced and mid-range ejection fraction (HFrEF: LVEF<40%; HFmrEF: LVEF 40-49%) in NYHA I with no history of decompensation within the previous 6 months. All patients underwent comprehensive baseline echocardiographic and electrocardiographic assessment. The primary endpoint was the composite of cardiovascular death, hospitalization and need for intensification of HF treatment within a 12 month follow-up period. The cumulative incidence of HF progression was 17.8%, with a median time to event of 193 days. Death and hospitalization due to HF accounted for three-quarters of the events. QRS duration ≥120ms and mitral regurgitation grade >1 showed to be significant predictors of HF progression (HR: 8.92, p<0.001; and HR: 4.10, p<0.001, respectively). Patients without these risk factors had a low incidence of clinical events (3.8%). In conclusion, almost one in five supposedly stable HF patients in NYHA I experience clinical progression in short-term follow-up. Simple electrocardiographic and echocardiographic predictors may be useful for risk stratification and could help to improve individual HF patient management and outcomes.
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3
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Xuefang F, Jianfeng Y, Shuiya S, Xiaoying C, Jiaqiang Z. Association of Cornell product with metabolic syndrome in middle-aged people in China. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00771-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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4
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Tan ES, Chan SP, Xu CF, Yap J, Richards AM, Ling LH, Sim D, Jaufeerally F, Yeo D, Loh SY, Ong HY, Leong KTG, Ng TP, Nyunt SZ, Feng L, Okin P, Lam CS, Lim TW. Cornell product is an ECG marker of heart failure with preserved ejection fraction. HEART ASIA 2019; 11:e011108. [PMID: 31244913 DOI: 10.1136/heartasia-2018-011108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/09/2019] [Accepted: 03/12/2019] [Indexed: 12/22/2022]
Abstract
Objective ECG markers of heart failure (HF) with preserved ejection fraction (HFpEF) are lacking. We hypothesised that the Cornell product (CP) is a risk marker of HFpEF and has prognostic utility in HFpEF. Methods CP =[(amplitude of R wave in aVL+depth of S wave in V3)×QRS] was measured on baseline 12-lead ECG in a prospective Asian population-based study of 606 healthy controls (aged 55±10 years, 45% men), 221 hypertensive controls (62±9 years, 58% men) and 242 HFpEF (68±12 years, 49% men); all with EF ≥50% and followed for 2 years for all-cause mortality and HF hospitalisations. Results CP increased across groups from healthy controls to hypertensive controls to HFpEF, and distinguished between HFpEF and hypertension with an optimal cut-off of ≥1800 mm*ms (sensitivity 40%, specificity 85%). Age, male sex, systolic blood pressure (SBP) and heart rate were independent predictors of CP ≥1800 mm*ms, and CP was associated with echocardiographic E/e' (r=0.27, p<0.01) and left ventricular mass index (r=0.46, p<0.01). Adjusting for clinical and echocardiographic variables and log N-terminal pro B-type natriuretic peptide (NT-proBNP), CP ≥1800 mm*ms was significantly associated with HFpEF (adjusted OR 2.7, 95% CI 1.0 to 7.0). At 2-year follow-up, there were 29 deaths and 61 HF hospitalisations, all within the HFpEF group. Even after adjusting for log NT-proBNP, clinical and echocardiographic variables, CP ≥1800 mm*ms remained strongly associated with a higher composite endpoint of all-cause mortality and HF hospitalisations (adjusted HR 2.1, 95% CI 1.2 to 3.5). Conclusion The Cornell product is an easily applicable ECG marker of HFpEF and predicts poor prognosis by reflecting the severity of diastolic dysfunction and LV hypertrophy.
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Affiliation(s)
- Eugene Sj Tan
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Healthy System, Singapore, Singapore
| | - Chang Fen Xu
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Jonathan Yap
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Arthur Mark Richards
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Healthy System, Singapore, Singapore.,Christchurch Heart Institute, University of Otago, Otago, New Zealand
| | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - David Sim
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.,Department of Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Fazlur Jaufeerally
- Department of Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore.,Department of Internal Medicine, Singapre General Hospital, Singapore, Singapore
| | - Daniel Yeo
- Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Seet Yoong Loh
- Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Hean Yee Ong
- Department of Cardiology, Khoo Teck Puat Hospital, Singapore, Singapore
| | | | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Shwe Zin Nyunt
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Liang Feng
- Department of Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Peter Okin
- Department of Cardiology, Weill Cornell Medical College, New York City, New York, USA
| | - Carolyn Sp Lam
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.,Department of Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Toon Wei Lim
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
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5
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Martínez-Sellés M, Díez-Villanueva P, Álvarez Garcia J, Ferrero-Gregori A, Vives-Borrás M, Worner F, Bardají A, Delgado JF, Vázquez R, González-Juanatey JR, Fernández-Aviles F, Cinca J. Influence of sex and pregnancy on survival in patients admitted with heart failure: Data from a prospective multicenter registry. Clin Cardiol 2018; 41:924-930. [PMID: 29774566 DOI: 10.1002/clc.22979] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Female sex is an independent predictor of better survival in patients with heart failure (HF), but the mechanism of this association is unknown. On the other hand, pregnancies have a strong influence on the cardiovascular system. HYPOTHESIS Sex and previous gestations might have a prognostic impact on 1-year mortality in patients admitted with HF. METHODS We conducted an observational, prospective, consecutive, multicenter registry of 1831 patients (756 females [41.2%]) admitted with HF. RESULTS Females had a more advanced age (75.2 ±11.4 vs 70.4 ±12.2 years), less ischemic heart disease (167 [25.3%] vs 446 [47.3%]), and higher left ventricular ejection fraction (52.0% ±16.6% vs 41.1% ±17.0%) than did men (all P values <0.001). During 1-year follow-up, 373 (20.4%) patients died (151 females and 222 males). Female sex was an independent predictor for survival (hazard ratio: 0.79, 95% confidence interval: 0.64-0.98, P = 0.03). In 504 women (65.9%), the exact number of previous pregnancies could be determined; 62 women (12.3%) had no previous pregnancies, 288 (57.1%) women had 1 or 2 pregnancies, and 154 women (30.6%) had ≥3 pregnancies. We found an association between the number of previous gestations and better survival (hazard ratio: 0.878, 95% confidence interval: 0.773-0.997, P = 0.045). CONCLUSIONS In patients admitted with HF, female sex and the number of previous pregnancies are independently associated with better 1-year survival.
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Affiliation(s)
- Manuel Martínez-Sellés
- Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Complutense, Madrid, Spain.,Universidad Europea, Madrid, Spain
| | | | - Jesús Álvarez Garcia
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreu Ferrero-Gregori
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Vives-Borrás
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Worner
- Cardiology Department, Hospital Universitari Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida, Lleida (IRB LLEIDA), Spain
| | - Alfredo Bardají
- Cardiology Department, Hospital Universitario de Tarragona Joan XXIII, IISPV, Universidad Rovira Virgili, Tarragona, Spain
| | - Juan F Delgado
- Cardiology Department, Hospital General Universitario 12 de Octubre, Madrid, Spain
| | - Rafael Vázquez
- Cardiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Francisco Fernández-Aviles
- Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Complutense, Madrid, Spain
| | - Juan Cinca
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Otaki Y, Watanabe T, Kinoshita D, Yokoyama M, Takahashi T, Toshima T, Sugai T, Murase T, Nakamura T, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Miyamoto T, Kubota I. Association of plasma xanthine oxidoreductase activity with severity and clinical outcome in patients with chronic heart failure. Int J Cardiol 2016; 228:151-157. [PMID: 27865177 DOI: 10.1016/j.ijcard.2016.11.077] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/05/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Oxidative stress due to purine degradation is associated with the development of chronic heart failure (CHF). Xanthine oxidoreductase (XOR) is a rate-limiting enzyme of purine degradation that plays a key role in uric acid (UA) production with a resultant increase in reactive oxygen species. However, the relationship between plasma XOR activity and CHF severity and clinical outcome remains unclear. METHODS AND RESULTS We measured XOR activity in 440 patients with CHF and 44 control subjects. Abnormally high and low XOR activities were identified based on the results for 95% of the control subjects (high and low XOR activities ≥120 and <33pmol/100μL/h, respectively). The prevalence rates of high and low XOR activities increased with advancing New York Heart Association functional class. There were 158 cardiac events during a median follow-up period of 1034days. Multivariate Cox proportional hazard regression analysis showed that both high and low XOR activities were significantly associated with cardiac events in patients with CHF after adjustment for confounding risk factors including serum UA and loop diuretic use. Kaplan-Meier analysis revealed that the cardiac event rate was significantly higher in patients with either high or low XOR activity. The net reclassification index was significantly improved by adding XOR activity to the basic risk factors. CONCLUSIONS We provide the first evidence of an association of plasma XOR activity with CHF severity and clinical outcome. Plasma XOR activity could be used to identify high-risk CHF patients and could be a therapeutic target for XOR inhibitors.
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Affiliation(s)
- Yoichiro Otaki
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
| | - Daisuke Kinoshita
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Miyuki Yokoyama
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Tetsuya Takahashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Taku Toshima
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takayuki Sugai
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takayo Murase
- Radioisotope and Chemical Analysis Center, Laboratory Management Department, Sanwa Kagaku Kenkyusho Co., Ltd., Mie, Japan
| | - Takashi Nakamura
- Pharmacological Study Group, Pharmaceutical Research Laboratories, Sanwa Kagaku Kenkyusho Co., Ltd., Mie, Japan
| | - Satoshi Nishiyama
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Hiroki Takahashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takanori Arimoto
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Tetsuro Shishido
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takuya Miyamoto
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Isao Kubota
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
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Comorbid renal tubular damage and hypoalbuminemia exacerbate cardiac prognosis in patients with chronic heart failure. Clin Res Cardiol 2015. [DOI: 10.1007/s00392-015-0899-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Xue YT, Tan QW, Li P, Mou SF, Liu SJ, Bao Y, Jiao HC, Su WG. Investigating the role of acute mental stress on endothelial dysfunction: a systematic review and meta-analysis. Clin Res Cardiol 2014; 104:310-9. [PMID: 25391292 DOI: 10.1007/s00392-014-0782-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/21/2014] [Indexed: 12/16/2022]
Abstract
Chronic stress is a known risk factor for both endothelial dysfunction and cardiovascular disease (CVD), but less is known of how acute mental stress affects the vasculature. In this systematic review and meta-analysis, we analyzed the impact of acute mental stress on flow-mediated dilation (FMD), an indicator of endothelial function. We searched the Medline, Cochrane, EMBASE, and ISI Web of Knowledge databases through May 2014, to identify publications in English-language journals. The primary outcome was the change in FMD from baseline to the time of measurement. We also assessed the risk of bias and the heterogeneity of included studies. Our search identified eight prospective studies, which displayed significant heterogeneity. Four studies measured FMD while the subject was performing the task; six measured FMD after the task had been completed. The total number of participants was 164. The pooled results indicate that FMD did not change significantly while the task was being performed (pooled difference in means: -0.853; 95 % confidence interval (CI), -3.926/2.220; P = 0.586); however, FMD measured after the task was completed was significantly less than baseline (pooled difference in means: -2.450; 95 %CI, -3.925/-0.975; P = 0.001). In conclusions, our findings provide evidence that an acute stressful experience has a delayed, negative impact on the function of the endothelium. Repeated exposure to short-term stress may lead to permanent injury of the vasculature. Therefore, assessment of patients' exposure to both repeated acute mental stress and chronic stress may be useful in determining their risk of developing CVD.
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Affiliation(s)
- Yi-Tao Xue
- Department of Cardiology, Shandong University School of Medicine Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 42 West Wenhua Road, Jinan, 250011, Shandong Province, China,
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9
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Maunganidze F, Woodiwiss AJ, Libhaber CD, Maseko MJ, Majane OHI, Norton GR. Left ventricular hypertrophy detection from simple clinical measures combined with electrocardiographic criteria in a group of African ancestry. Clin Res Cardiol 2014; 103:921-9. [DOI: 10.1007/s00392-014-0730-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
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