1
|
Edwards CV, Ferri GM, Villegas-Galaviz J, Ghosh S, Bawa PS, Wang F, Klimtchuk E, Ajayi TB, Morgan GJ, Prokaeva T, Staron A, Ruberg FL, Sanchorawala V, Giadone RM, Murphy GJ. Abnormal global longitudinal strain and reduced serum inflammatory markers in cardiac AL amyloidosis patients without significant amyloid fibril deposition. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.14.584987. [PMID: 38558967 PMCID: PMC10980073 DOI: 10.1101/2024.03.14.584987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Cardiac dysfunction in AL amyloidosis is thought to be partly related to the direct impact of AL LCs on cardiomyocyte function, with the degree of dysfunction at diagnosis as a major determinant of clinical outcomes. Nonetheless, mechanisms underlying LC-induced myocardial toxicity are not well understood. Methods We identified gene expression changes correlating with human cardiac cells exposed to a cardiomyopathy-associated κAL LC. We then sought to confirm these findings in a clinical dataset by focusing on clinical parameters associated with the pathways dysregulated at the gene expression level. Results Upon exposure to a cardiomyopathy-associated κAL LC, cardiac cells exhibited gene expression changes related to myocardial contractile function and inflammation, leading us to hypothesize that there could be clinically detectable changes in GLS on echocardiogram and serum inflammatory markers in patients. Thus, we identified 29 patients with normal IVSd but abnormal cardiac biomarkers suggestive of LC-induced cardiac dysfunction. These patients display early cardiac biomarker staging, abnormal GLS, and significantly reduced serum inflammatory markers compared to patients with clinically evident amyloid fibril deposition. Conclusion Collectively, our findings highlight early molecular and functional signatures of cardiac AL amyloidosis, with potential impact for developing improved patient biomarkers and novel therapeutics.
Collapse
|
2
|
Kosum P, Siranart N, Mattanapojanat N, Phutinart S, Kongruttanachok N, Sinphurmsukskul S, Siwamogsatham S, Puwanant S, Ariyachaipanich A. GDF-15: a novel biomarker of heart failure predicts short-term and long-term heart-failure rehospitalization and short-term mortality in patients with acute heart failure syndrome. BMC Cardiovasc Disord 2024; 24:151. [PMID: 38475710 DOI: 10.1186/s12872-024-03802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Acute heart failure (AHF) is a potentially life-threatening clinical syndrome, usually requiring hospital admission. Growth Differentiation Factor-15 (GDF-15) is a distant member of the transforming growth factor-β. The increased expression of GDF-15 has been observed during heart failure (HF) and is associated with worse outcomes. However, the relationship between GDF-15 and AHF is not well understood with limited evidence among Thai patients. PURPOSE Investigate the correlation between biomarker levels (measured upon admission and discharge) and short- and long-term adverse outcomes, encompassing all-cause mortality and heart-failure (HF) rehospitalization (at 30, 90, and 180 days, as well as throughout the entire follow-up duration) in individuals experiencing acute HF. METHODS This is a prospective single-center investigation involving patients admitted for AHF. Biomarkers, including GDF-15, high-sensitivity troponin T (hsTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP), were assessed upon admission and discharge. Outcomes, including all-cause mortality and HF rehospitalization, were examined. Logarithmic transformations were applied to the biomarker variables for subsequent analysis. Univariate and multivariate analyses of cause-specific hazards were conducted using the Cox proportional hazards regression model, while subdistribution hazards were assessed using the Fine-Gray regression model to evaluate outcomes. RESULTS A total of 84 patients were enrolled (mean age of 69 years, 52% females). The GDF-15 level significantly decreased during admission (median at the time of admission 6,346 pg/mL, median at the time of discharge 5,711 pg/mL; p < 0.01). All-cause mortality at 30 days and 180 days were 6.0% and 16.7%, respectively. HF rehospitalization at 30 days and 180 days were 15.5% and 28.6%, respectively. Univariate analysis showed that total orthoedema congestion score (p = 0.02) and admission GDF-15 level (p = 0.01) were associated with 30-day all-cause mortality, whereas hsTnT or NT-proBNP levels did not show significant associations. However, higher levels of NT-proBNP upon admission were associated with all-cause mortality when considering the entire follow-up period (p < 0.01). Both univariate and multivariate analyses demonstrated that lower discharge GDF-15 levels and a greater reduction in GDF-15 levels from admission to discharge were associated with a lower risk of 30-day rehospitalization. Similarly, univariate analysis revealed that a greater reduction in NT-proBNP levels from admission to discharge was associated with lower 30-day rehospitalization rates. At 180 days, a greater reduction in GDF-15 levels remained associated with lower hazards and incidence of rehospitalization. CONCLUSION The significant decrease in Growth Differentiation Factor-15 (GDF-15) levels during hospitalization suggests its potential as a dynamic marker reflecting the course of AHF. Importantly, higher GDF-15 levels at admission were associated with an increased risk of 30-day all-cause mortality, highlighting its prognostic value in this patient population. Moreover, lower discharge GDF-15 levels, reductions in GDF-15 from admission to discharge, and decreases in NT-proBNP from admission to discharge were associated with a reduced risk of 30-day rehospitalization.
Collapse
Affiliation(s)
- Paisit Kosum
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Zip Code 10330, Thailand
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Noppachai Siranart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Somkiat Phutinart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Narisorn Kongruttanachok
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supanee Sinphurmsukskul
- Excellent Center for Organ Transplantation, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Sarawut Siwamogsatham
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chula Clinical Research Center (ChulaCRC), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sarinya Puwanant
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Zip Code 10330, Thailand
- Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Aekarach Ariyachaipanich
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Zip Code 10330, Thailand.
- Excellent Center for Organ Transplantation, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
| |
Collapse
|
3
|
Sawalha K, Norgard NB, Drees BM, López-Candales A. Growth Differentiation Factor 15 (GDF-15), a New Biomarker in Heart Failure Management. Curr Heart Fail Rep 2023; 20:287-299. [PMID: 37289373 DOI: 10.1007/s11897-023-00610-4] [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] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
The emergence of biomarkers across medicine's subspecialties continues to evolve. In essence, a biomarker is a biological observation that clearly substitutes a clinical endpoint or intermediate outcome not only are more difficult to observe but also, biomarkers are easier, less expensive and could be measured over shorter periods. In general, biomarkers are versatile and not only used for disease screening and diagnosis but, most importantly, for disease characterization, monitoring, and determination of prognosis as well as individualized therapeutic responses. Obviously, heart failure (HF) is no exception to the use of biomarkers. Currently, natriuretic peptides are the most used biomarkers for both diagnosis and prognostication, while their role in the monitoring of treatment is still debatable. Although several other new biomarkers are currently under investigation regarding diagnosis and determination of prognosis, none of them are specific for HF, and none are recommended for routine clinical use at present. However, among these emerging biomarkers, we would like to highlight the potential for growth differentiation factor (GDF)-15 as a plausible new biomarker that could be helpful in providing prognostic information regarding HF morbidity and mortality.
Collapse
Affiliation(s)
- Khalid Sawalha
- Cardiometabolic Medicine Fellowship, University of Missouri-Kansas City, Kansas City, MO, USA.
- Section of Cardiovascular Medicine, University Health, Truman Medical Center, University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO, 64108, USA.
| | - Nicholas B Norgard
- Department of Medicine, University Health Truman Medical Center, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Betty M Drees
- Department(s) of Internal Medicine, Biomedical and Health Informatics, Section of Endocrinology, UMKC School of Medicine, Kansas City, MO, USA
| | - Angel López-Candales
- Section of Cardiovascular Medicine, University Health, Truman Medical Center, University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO, 64108, USA
| |
Collapse
|
4
|
Dmour BA, Costache AD, Dmour A, Huzum B, Duca ȘT, Chetran A, Miftode RȘ, Afrăsânie I, Tuchiluș C, Cianga CM, Botnariu G, Șerban LI, Ciocoiu M, Bădescu CM, Costache II. Could Endothelin-1 Be a Promising Neurohormonal Biomarker in Acute Heart Failure? Diagnostics (Basel) 2023; 13:2277. [PMID: 37443671 DOI: 10.3390/diagnostics13132277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Acute heart failure (AHF) is a life-threatening condition with high morbidity and mortality. Even though this pathology has been extensively researched, there are still challenges in establishing an accurate and early diagnosis, determining the long- and short-term prognosis and choosing a targeted therapeutic strategy. The use of reliable biomarkers to support clinical judgment has been shown to improve the management of AHF patients. Despite a large pool of interesting candidate biomarkers, endothelin-1 (ET-1) appears to be involved in multiple aspects of AHF pathogenesis that include neurohormonal activation, cardiac remodeling, endothelial dysfunction, inflammation, atherosclerosis and alteration of the renal function. Since its discovery, numerous studies have shown that the level of ET-1 is associated with the severity of symptoms and cardiac dysfunction in this pathology. The purpose of this paper is to review the existing information on ET-1 and answer the question of whether this neurohormone could be a promising biomarker in AHF.
Collapse
Affiliation(s)
- Bianca-Ana Dmour
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Alexandru Dan Costache
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iași, Romania
| | - Awad Dmour
- Department of Orthopedics and Traumatology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Orthopaedics and Traumatology, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Bogdan Huzum
- Department of Orthopaedics and Traumatology, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Physiology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ștefania Teodora Duca
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Cardiology Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Adriana Chetran
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Cardiology Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Radu Ștefan Miftode
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Cardiology Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Irina Afrăsânie
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Cardiology Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Cristina Tuchiluș
- Department of Microbiology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Microbiology Laboratory, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Corina Maria Cianga
- Immunology Laboratory, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Immunology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Gina Botnariu
- Unit of Diabetes, Nutrition and Metabolic Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Clinical Center of Diabetes, Nutrition and Metabolic Diseases, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Lăcrămioara Ionela Șerban
- Department of Physiology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Manuela Ciocoiu
- Department of Morpho-Functional Sciences II, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Codruța Minerva Bădescu
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Internal Medicine Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Cardiology Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania
| |
Collapse
|
5
|
Binder MS, Yanek LR, Yang W, Butcher B, Norgard S, Marine JE, Kolandaivelu A, Chrispin J, Fedarko NS, Calkins H, O'Rourke B, Wu KC, Tomaselli GF, Barth AS. Growth Differentiation Factor-15 Predicts Mortality and Heart Failure Exacerbation But Not Ventricular Arrhythmias in Patients With Cardiomyopathy. J Am Heart Assoc 2023; 12:e8023. [PMID: 36718879 PMCID: PMC9973637 DOI: 10.1161/jaha.122.026003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Heart failure (HF) has been increasing in prevalence, and a need exists for biomarkers with improved predictive and prognostic ability. GDF-15 (growth differentiation factor-15) is a novel biomarker associated with HF mortality, but no serial studies of GDF-15 have been conducted. This study aimed to investigate the association between GDF-15 levels over time and the occurrence of ventricular arrhythmias, HF hospitalizations, and all-cause mortality. Methods and Results We used a retrospective case-control design to analyze 148 patients with ischemic and nonischemic cardiomyopathies and primary prevention implantable cardioverter-defibrillator (ICD) from the PROSe-ICD (Prospective Observational Study of the ICD in Sudden Cardiac Death Prevention) cohort. Patients had blood drawn every 6 months and after each appropriate ICD therapy and were followed for a median follow-up of 4.6 years, between 2005 to 2019. We compared serum GDF-15 levels within ±90 days of an event among those with a ventricular tachycardia/fibrillation event requiring ICD therapies and those hospitalized for decompensated HF. A comparator/control group comprised patients with GDF-15 levels available during 2-year follow-up periods without events. Median follow-up was 4.6 years in the 148 patients studied (mean age 58±12, 27% women). The HF cohort had greater median GDF-15 values within 90 days (1797 pg/mL) and 30 days (2039 pg/mL) compared with the control group (1062 pg/mL, both P<0.0001). No difference was found between the ventricular tachycardia/fibrillation subgroup within 90 days (1173 pg/mL, P=0.60) or 30 days (1173 pg/mL, P=0.78) and the control group. GDF-15 was also significantly predictive of mortality (hazard ratio, 3.17 [95% CI, 2.33-4.30]). Conclusions GDF-15 levels are associated with HF hospitalization and mortality but not ventricular arrhythmic events.
Collapse
MESH Headings
- Aged
- Female
- Humans
- Male
- Middle Aged
- Arrhythmias, Cardiac/diagnosis
- Arrhythmias, Cardiac/therapy
- Arrhythmias, Cardiac/complications
- Biomarkers
- Cardiomyopathies/therapy
- Cardiomyopathies/complications
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Defibrillators, Implantable
- Growth Differentiation Factor 15
- Heart Failure/diagnosis
- Heart Failure/therapy
- Heart Failure/complications
- Retrospective Studies
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/therapy
- Tachycardia, Ventricular/complications
- Ventricular Fibrillation/diagnosis
- Ventricular Fibrillation/therapy
- Ventricular Fibrillation/complications
Collapse
Affiliation(s)
- M. Scott Binder
- Department of MedicineVirginia Tech CarilionRoanokeVA
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Lisa R. Yanek
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Wanjun Yang
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Barbara Butcher
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Sanaz Norgard
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Joseph E. Marine
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | | | - Jonathan Chrispin
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Neal S. Fedarko
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Hugh Calkins
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Brian O'Rourke
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Katherine C. Wu
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Gordon F. Tomaselli
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
- Albert Einstein College of Medicine and Montefiore MedicineBronxNY
| | - Andreas S. Barth
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| |
Collapse
|
6
|
Miftode RS, Constantinescu D, Cianga CM, Petris AO, Costache II, Mitu O, Miftode IL, Mitu I, Timpau AS, Duca ST, Costache AD, Cianga P, Serban IL. A Rising Star of the Multimarker Panel: Growth Differentiation Factor-15 Levels Are an Independent Predictor of Mortality in Acute Heart Failure Patients Admitted to an Emergency Clinical Hospital from Eastern Europe. Life (Basel) 2022; 12:life12121948. [PMID: 36556311 PMCID: PMC9784402 DOI: 10.3390/life12121948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: Acute heart failure (HF) represents one of the most common yet extremely severe presentations in emergency services worldwide, requiring prompt diagnosis, followed by an adequate therapeutic approach, and a thorough risk stratification. Natriuretic peptides (NPs) are currently the most widely implemented biomarkers in acute HF, but due to their lack of specificity, they are mainly used as ruling-out criteria. Growth differentiation factor-15 (GDF-15) is a novel molecule expressing different pathophysiological pathways in HF, such as fibrosis, remodeling, and oxidative stress. It is also considered a very promising predictor of mortality and poor outcome. In this study, we aimed to investigate the GDF-15’s expression and particularities in patients with acute HF, focusing mainly on its role as a prognosis biomarker, either per se or as part of a multimarker panel. (2) Methods: This unicentric prospective study included a total of 173 subjects, divided into 2 subgroups: 120 patients presented in emergency with acute HF, while 53 were ambulatory-evaluated controls with chronic HF. At admission, all patients were evaluated according to standard clinical echocardiography and laboratory panel, including the assessment of GDF-15. (3) Results: The levels of GDF-15 were significantly higher in patients with acute HF, compared to controls [596 (305−904) vs. 216 (139−305) ng/L, p < 0.01]. GDF-15 also exhibited an adequate diagnostic performance in acute HF, expressed as an area under the curve (AUC) of 0.883 [confidence interval (CI) 95%: 0.828−0.938], similar to that of NT-proBNP (AUC: 0.976, CI 95%: 0.952−1.000), or troponin (AUC: 0.839, CI 95%: 0.733−0.944). High concentrations of GDF-15 were significantly correlated with mortality risk. In a multivariate regression model, GDF-15 was the most important predictor of a poor outcome, superior to NT-proBNP or troponin. (4) Conclusions: GDF-15 proved to be a reliable tool in the multimarker assessment of patients with acute HF. Compared to the gold standard NT-proBNP, GDF-15 presented a similar diagnostic performance, doubled by a significantly superior prognostic value, making it worth being included in a standardized multimarker panel.
Collapse
Affiliation(s)
- Radu-Stefan Miftode
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Daniela Constantinescu
- Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Corina-Maria Cianga
- Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Antoniu-Octavian Petris
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Irina-Iuliana Costache
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
- Correspondence: (I.-I.C.); (P.C.)
| | - Ovidiu Mitu
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Ionela-Larisa Miftode
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Ivona Mitu
- Department of Morpho-Functional Sciences II, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Amalia-Stefana Timpau
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Stefania-Teodora Duca
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Alexandru-Dan Costache
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| | - Petru Cianga
- Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
- Correspondence: (I.-I.C.); (P.C.)
| | - Ionela-Lacramioara Serban
- Department of Morpho-Functional Sciences II, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
| |
Collapse
|
7
|
Bardan S, Kvaslerud AB, Andresen K, Kløve SF, Edvardsen T, Gullestad L, Broch K. Intravenous ferric derisomaltose in iron-deficient patients undergoing transcatheter aortic valve implantation due to severe aortic stenosis: study protocol of the randomised controlled IIISAS trial. BMJ Open 2022; 12:e059546. [PMID: 36691165 PMCID: PMC9442485 DOI: 10.1136/bmjopen-2021-059546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/13/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Iron deficiency is a prevalent comorbidity in patients with severe aortic stenosis and may be associated with procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI). In the Intravenous Iron Supplement for Iron Deficiency in Patients with Severe Aortic Stenosis (IIISAS) trial, we aim to examine whether a single administration of ferric derisomaltose can improve physical capacity after TAVI. METHODS AND ANALYSIS This randomised, double-blind, placebo-controlled trial aims to enrol 150 patients with iron deficiency who are scheduled for TAVI due to severe aortic stenosis. The study drug and matching placebo are administered approximately 3 months prior to TAVI, and the patients are followed for 3 months after TAVI. Inclusion criteria are iron deficiency, defined as serum ferritin<100 µg/L or ferritin between 100 and 300 µg/L in combination with a transferrin saturation<20% and written informed consent. Exclusion criteria include haemoglobin<10 g/dL, red blood cell disorders, end-stage kidney failure, intolerance to ferric derisomaltose, and ongoing infections. The primary endpoint is the baseline-adjusted distance walked on a 6 min walk test (6MWT) 3 months after TAVI. Secondary end points include quality of life, New York Heart Association functional class (NYHA functional class), and skeletal muscle strength. ETHICS AND DISSEMINATION Ethical approval was obtained from the Regional Committee for Medical and Health Research of South-Eastern Norway and The Norwegian Medicines Agency. Enrolment has begun, and results are expected in 2022. The results of the IIISAS trial will be disseminated by presentations at international and national conferences and by publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04206228.
Collapse
Affiliation(s)
- Sara Bardan
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anette Borger Kvaslerud
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Cardiac Research Center and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristoffer Andresen
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Sophie Foss Kløve
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Thor Edvardsen
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Lars Gullestad
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Cardiac Research Center and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kaspar Broch
- Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
8
|
Ceelen D, Voors AA, Tromp J, van Veldhuisen DJ, Dickstein K, de Boer RA, Lang CC, Anker SD, Ng LL, Metra M, Ponikowski P, Figarska SM. Pathophysiological pathways related to high plasma GDF-15 concentrations in patients with heart failure. Eur J Heart Fail 2022; 24:308-320. [PMID: 34989084 PMCID: PMC9302623 DOI: 10.1002/ejhf.2424] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/24/2021] [Accepted: 01/03/2022] [Indexed: 11/11/2022] Open
Abstract
AIMS Elevated concentrations of Growth Differentiation factor 15 (GDF-15) in patients with heart failure (HF) have been consistently associated with worse clinical outcomes, but what disease mechanisms high GDF-15 concentrations represent remains unclear. Here, we aim to identify activated pathophysiological pathways related to elevated GDF-15 expression in patients with HF. METHODS AND RESULTS In 2279 patients with HF, we measured circulating levels of 363 biomarkers. Then, we performed a pathway over-representation analysis to identify key biological pathways between patients in the highest and lowest GDF-15 concentration quartiles. Data were validated in an independent cohort of 1705 patients with HF. In both cohorts, the strongest up-regulated biomarkers in those with high GDF-15 were fibroblast growth factor 23 (FGF-23), death receptor 5 (TRAIL-R2), WNT1-inducible-signaling pathway protein 1 (WISP-1), TNF Receptor Superfamily Member 11a (TNFRSF11A), leukocyte immunoglobulin-like receptor subfamily B member 4 (LILRB4), and Trefoil Factor 3 (TFF3). Pathway over-representation analysis revealed that high GDF-15 patients had increased activity of pathways related to inflammatory processes, notably positive regulation of chemokine production; response to interleukin 6 (IL-6); tumour necrosis factor (TNF) and death receptor activity; and positive regulation of T cell differentiation and inflammatory response. Furthermore, we found pathways involved in regulation of insulin-like growth factor (IGF) receptor signalling and regulatory pathways of tissue, bones, and branching structures. GDF-15 quartiles significantly predicted all-cause mortality and HF hospitalization. CONCLUSION Patients with HF and high plasma concentrations of GDF-15 are characterized by increased activation of inflammatory pathways and pathways related to IGF-1 regulation and bone/tissue remodelling.
Collapse
Affiliation(s)
- Daan Ceelen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Adriaan A Voors
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jasper Tromp
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,National Heart Centre Singapore, Singapore
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Kenneth Dickstein
- University of Bergen, Bergen, Norway.,Stavanger University Hospital, Stavanger, Norway
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chim C Lang
- School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Stefan D Anker
- Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Germany
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Marco Metra
- Institute of Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Piotr Ponikowski
- Department of Heart Diseases, Wrocław Medical University, Wroclaw, Poland; Center for Heart Diseases, University Hospital in Wrocław, Wroclaw, Poland
| | - Sylwia M Figarska
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
9
|
Luo JW, Duan WH, Song L, Yu YQ, Shi DZ. A Meta-Analysis of Growth Differentiation Factor-15 and Prognosis in Chronic Heart Failure. Front Cardiovasc Med 2021; 8:630818. [PMID: 34805295 PMCID: PMC8602355 DOI: 10.3389/fcvm.2021.630818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 10/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Previous studies had reported increased circulating concentrations of growth differentiation factor-15 (GDF-15) in chronic heart failure (CHF), suggesting the potential prognostic significance of GDF-15 in this setting. To verify the relationship between the circulating GDF-15 levels and prognosis of CHF patients, we conducted an updated evidence-based meta-analysis. Methods: A comprehensive literature retrieval of PubMed, EMBASE, and Cochrane library was performed to collect the qualified studies that analyzed the prognostic value of GDF-15 in CHF from the inception of these online databases to September 25, 2021. The hazard ratio (HR) calculated for logGDF-15 of all-cause death and the related 95% confidence interval (CI) in multivariate analysis were used to measure the effect size. Additionally, subgroup analyses stratified by characteristics of the study participants were conducted for incremental evidence of GDF-15 in CHF with different clinical status. Results: A total of ten eligible studies involving 6,244 CHF patients were finally taken into the quantitative analysis. Results in the random-effects model indicated that there was an increased risk of 6% in all-cause mortality with a per 1LnU increase in baseline GDF-15 concentration (HR: 1.06, 95% CI: 1.03–1.10, P < 0.001). In stratified analyses, the association of GDF-15 with risk of all-cause mortality was found among chronic ischemic HF patients (HR:1.75, 95%CI: 1.24–2.48, P = 0.002), while the association was not found among chronic nonischemic HF patients (HR:1.01, 95%CI: 1.00–1.02, P = 0.219). Conclusion: The elevated GDF-15 is associated with an increased risk of all-cause mortality in CHF, especially, among CHF patients with ischemic etiology. The circulating GDF-15 might be a prognostic indicator in CHF patients. Registration Number:https://www.crd.york.ac.uk/PROSPERO; CRD42020210796.
Collapse
Affiliation(s)
- Jin-Wen Luo
- Beijing University of Chinese Medicine, Beijing, China
| | - Wen-Hui Duan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Lei Song
- Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Qiao Yu
- Beijing University of Chinese Medicine, Beijing, China
| | - Da-Zhuo Shi
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| |
Collapse
|
10
|
Álvarez-García J, García-Osuna Á, Vives-Borrás M, Ferrero-Gregori A, Martínez-Sellés M, Vázquez R, González-Juanatey JR, Rivera M, Segovia J, Pascual-Figal D, Bover R, Bascompte R, Delgado J, Grau Sepúlveda A, Bardají A, Pérez-Villa F, Zamorano JL, Crespo-Leiro M, Sánchez PL, Ordoñez-Llanos J, Cinca J. A 3-Biomarker 2-Point-Based Risk Stratification Strategy in Acute Heart Failure. Front Physiol 2021; 12:708890. [PMID: 34744758 PMCID: PMC8569896 DOI: 10.3389/fphys.2021.708890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/04/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction and Objectives: Most multi-biomarker strategies in acute heart failure (HF) have only measured biomarkers in a single-point time. This study aimed to evaluate the prognostic yielding of NT-proBNP, hsTnT, Cys-C, hs-CRP, GDF15, and GAL-3 in HF patients both at admission and discharge. Methods: We included 830 patients enrolled consecutively in a prospective multicenter registry. Primary outcome was 12-month mortality. The gain in the C-index, calibration, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) was calculated after adding each individual biomarker value or their combination on top of the best clinical model developed in this study (C-index 0.752, 0.715-0.789) and also on top of 4 currently used scores (MAGGIC, GWTG-HF, Redin-SCORE, BCN-bioHF). Results: After 12-month, death occurred in 154 (18.5%) cases. On top of the best clinical model, the addition of NT-proBNP, hs-CRP, and GDF-15 above the respective cutoff point at admission and discharge and their delta during compensation improved the C-index to 0.782 (0.747-0.817), IDI by 5% (p < 0.001), and NRI by 57% (p < 0.001) for 12-month mortality. A 4-risk grading categories for 12-month mortality (11.7, 19.2, 26.7, and 39.4%, respectively; p < 0.001) were obtained using combination of these biomarkers. Conclusion: A model including NT-proBNP, hs-CRP, and GDF-15 measured at admission and discharge afforded a mortality risk prediction greater than our clinical model and also better than the most currently used scores. In addition, this 3-biomarker panel defined 4-risk categories for 12-month mortality.
Collapse
Affiliation(s)
- Jesús Álvarez-García
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.,Cardiology Department, Hospital Ramón y Cajal, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Álvaro García-Osuna
- Biochemistry Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Barcelona, Spain
| | - Miquel Vives-Borrás
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | - Andreu Ferrero-Gregori
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | - Manuel Martínez-Sellés
- Cardiology Department, Hospital Universitario Gregorio Marañón, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Rafael Vázquez
- Cardiology Department, Hospital Puerta del Mar, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Cádiz, Spain
| | - José R González-Juanatey
- Cardiology Department, Hospital Clínico, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, Spain
| | - Miguel Rivera
- Cardiology Department, Hospital La Fe, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Valencia, Spain
| | - Javier Segovia
- Cardiology Department, Hospital Puerta de Hierro-Majadahonda, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Domingo Pascual-Figal
- Cardiology Department, Hospital Virgen de la Arrixaca, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Murcia, Spain
| | - Ramón Bover
- Cardiology Department, Hospital Clínico San Carlos, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Ramón Bascompte
- Cardiology Department, Hospital Arnau de Vilanova, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Lleida, Spain
| | - Juan Delgado
- Cardiology Department, Hospital 12 de Octubre, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Andrés Grau Sepúlveda
- Cardiology Department, Hospital Universitario Son Espases, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Palma de Mallorca, Spain
| | - Alfredo Bardají
- Cardiology Department, Hospital Juan XXIII, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Tarragona, Spain
| | - Félix Pérez-Villa
- Cardiology Department, Hospital Clinic, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | - José Luis Zamorano
- Cardiology Department, Hospital Ramón y Cajal, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Marisa Crespo-Leiro
- Cardiology Department, Hospital Universitario A Coruna, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), A Coruna, Spain
| | - Pedro Luis Sánchez
- Cardiology Department, Hospital Clínico Universitario, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Salamanca, Spain
| | - Jordi Ordoñez-Llanos
- Biochemistry Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Barcelona, Spain
| | - Juan Cinca
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| |
Collapse
|
11
|
Meijers WC, Bayes-Genis A, Mebazaa A, Bauersachs J, Cleland JGF, Coats AJS, Januzzi JL, Maisel AS, McDonald K, Mueller T, Richards AM, Seferovic P, Mueller C, de Boer RA. Circulating heart failure biomarkers beyond natriuretic peptides: review from the Biomarker Study Group of the Heart Failure Association (HFA), European Society of Cardiology (ESC). Eur J Heart Fail 2021; 23:1610-1632. [PMID: 34498368 PMCID: PMC9292239 DOI: 10.1002/ejhf.2346] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022] Open
Abstract
New biomarkers are being evaluated for their ability to advance the management of patients with heart failure. Despite a large pool of interesting candidate biomarkers, besides natriuretic peptides virtually none have succeeded in being applied into the clinical setting. In this review, we examine the most promising emerging candidates for clinical assessment and management of patients with heart failure. We discuss high-sensitivity cardiac troponins (Tn), procalcitonin, novel kidney markers, soluble suppression of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor-15 (GDF-15), cluster of differentiation 146 (CD146), neprilysin, adrenomedullin (ADM), and also discuss proteomics and genetic-based risk scores. We focused on guidance and assistance with daily clinical care decision-making. For each biomarker, analytical considerations are discussed, as well as performance regarding diagnosis and prognosis. Furthermore, we discuss potential implementation in clinical algorithms and in ongoing clinical trials.
Collapse
Affiliation(s)
- Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain
| | - Alexandre Mebazaa
- Inserm U942-MASCOT; Université de Paris; Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière; FHU PROMICE, Paris, France.,Université de Paris, Paris, France.,Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière, Paris, France.,FHU PROMICE, Paris, France
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - John G F Cleland
- Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow; National Heart & Lung Institute, Imperial College London, London, UK
| | - Andrew J S Coats
- Monash University, Melbourne, Australia.,University of Warwick, Coventry, UK
| | | | | | | | - Thomas Mueller
- Department of Clinical Pathology, Hospital of Bolzano, Bolzano, Italy
| | - A Mark Richards
- Christchurch Heart Institute, Christchurch, New Zealand.,Cardiovascular Research Institute, National University of Singapore, Singapore
| | - Petar Seferovic
- Faculty of Medicine, Belgrade University, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgarde, Serbia
| | | | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
12
|
di Candia AM, de Avila DX, Moreira GR, Villacorta H, Maisel AS. Growth differentiation factor-15, a novel systemic biomarker of oxidative stress, inflammation, and cellular aging: Potential role in cardiovascular diseases. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2021; 9:100046. [PMID: 38559370 PMCID: PMC10978141 DOI: 10.1016/j.ahjo.2021.100046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 04/04/2024]
Abstract
Growth differentiation factor-15 (GDF-15) is a cytokine upregulated in multiple pathological conditions where oxidative stress, endothelial dysfunction, tissue aging, and chronic inflammation are the hallmarks. GDF-15 has many sources of production, including cardiac and vascular myocytes, endothelial cells, adipocytes and macrophages in response to metabolic stress, oncogenic transformation and the burden of proinflammatory cytokines or reactive oxygen species. Although the main sources of GDF-15 are extracardiac tissues, it has been shown to be elevated in many cardiac disorders. In experimental models of heart disease, GDF-15 release is induced after an ischemic insult and in pressure overload scenarios. Likewise, in recent years, an increasing body of evidence has emerged linking GDF-15 to the risk of mortality in acute coronary syndromes, atrial fibrillation and heart failure. Additionally, GDF-15 has been shown to add prognostic information beyond other conventional biomarkers such as natriuretic peptides and cardiac troponins. Further studies are needed to assess whether the incorporation of GDF-15 into clinical practice can improve cardiovascular outcomes.
Collapse
Affiliation(s)
- Angelo Michele di Candia
- Postgraduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Diane Xavier de Avila
- Postgraduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Gustavo Rodolfo Moreira
- Postgraduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Humberto Villacorta
- Postgraduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Alan S. Maisel
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla, United States of America
| |
Collapse
|
13
|
Andreasová T, Vránová J, Vondráková D, Sedláčková L, Zákostelská ZJ, Neužil P, Málek F. Role of biomarkers of cardiac remodeling, myofibrosis, and inflammation in assessment of disease severity in euvolemic patients with chronic stable heart failure. J Int Med Res 2021; 48:300060520947869. [PMID: 32815444 PMCID: PMC7444138 DOI: 10.1177/0300060520947869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study aimed to determine the importance of biomarkers of chronic heart failure (CHF) for assessing disease severity in euvolemic stable patients. PATIENTS AND METHODS N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor (GDF)-15, galectin-3, cystatin-C, soluble suppression of tumorigenicity 2 (sST2), tissue type inhibitor of matrix metalloproteinase (TIMP)-1, and ceruloplasmin levels were measured in euvolemic patients with stable CHF. Severity of CHF was defined by echocardiographic and biochemical parameters. RESULTS In 160 patients (123 men and 37 women, mean age: 65.8±12.2 years), we found strong associations between NT-proBNP and bilirubin levels (r = 0.434) and the estimated glomerular filtration rate (r = -0.321). GDF-15 and cystatin-C levels were significantly correlated with parameters of kidney function. In multivariable regression analysis, NT-proBNP levels were associated with the left ventricular ejection fraction and left ventricular end-systolic volume (coefficient of determination R2 = 0.777). Additionally, GDF-15 levels were correlated with urea levels (R2 = 0.742), and cystatin C levels were correlated with urea and bilirubin levels (R2 = 0.732). CONCLUSION Besides NT-proBNP, GDF-15 and cystatin C are promising biomarkers for establishing the severity of disease in euvolemic patients with stable CHF.
Collapse
Affiliation(s)
- Táňa Andreasová
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic.,Third Faculty of Medicine, Charles University, Prague
| | - Jana Vránová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University, Prague
| | | | - Lenka Sedláčková
- Department of Clinical Biochemistry, Haematology and Immunology, Na Homolce Hospital, Prague Czech Republic
| | | | - Petr Neužil
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Filip Málek
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic.,Third Faculty of Medicine, Charles University, Prague
| |
Collapse
|
14
|
Willinger L, Brudy L, Meyer M, Oberhoffer-Fritz R, Ewert P, Müller J. Prognostic value of non-acute high sensitive troponin-T for cardiovascular morbidity and mortality in adults with congenital heart disease: A systematic review. J Cardiol 2021; 78:206-212. [PMID: 33678488 DOI: 10.1016/j.jjcc.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Elevation of high-sensitivity troponin-T (hs-TnT) is linked to cardiovascular morbidity and mortality. However, its prognostic value for survival and cardiovascular events and its relation to clinical characteristics and cardiac function parameters in clinically asymptomatic adults with congenital heart disease (ACHD) needs further exploration. METHODS A systematic literature search was performed in PubMed and Cochrane from 2010 to May 2020 for hs-TnT as a prognostic marker in ACHD. Three independent reviewers evaluated the articles according to the Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. Overall, eight studies with a total of 2162 ACHD patients (18-63 years) were included. RESULTS Hs-TnT level was elevated in 8-26% of asymptomatic ACHD. The follow-up for all-cause mortality and cardiovascular events ranged from 3.0 to 5.6 years and in 8-38% of the participants cardiac endpoints were reached. Throughout the included studies, elevated hs-TnT was found to be an independent predictor for survival and heart failure in stable ACHD. Serial hs-TnT measurement was found to be beneficial over single measurement. Hs-TnT levels were correlated with male sex, higher age, and higher New York Heart Association class and associated with several cardiac dysfunction parameters. CONCLUSION More scientific research investigating the prognostic value of hs-TnT in stable ACHD is needed and the clinical relevance to guide aftercare has still to be determined.
Collapse
Affiliation(s)
- Laura Willinger
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Leon Brudy
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Michael Meyer
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany.
| |
Collapse
|
15
|
May BM, Pimentel M, Zimerman LI, Rohde LE. GDF-15 as a Biomarker in Cardiovascular Disease. Arq Bras Cardiol 2021; 116:494-500. [PMID: 33566936 PMCID: PMC8159541 DOI: 10.36660/abc.20200426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022] Open
Abstract
In the last years, several diagnostic and prognostic biomarkers have been studied in cardiovascular disease. Growth differentiation factor-15 (GDF-15), a cytokine belonging to the transforming growth factor- (TGF-) family, is highly up-regulated in stress and inflammatory conditions and has been correlated to myocardial injury and pressure cardiac overload in animal models. This new biomarker has been positively correlated with increased risk of cardiovascular events in population studies and shown an independent predictor of mortality in patients with coronary artery disease and heart failure. This review aimed to summarize the current evidence on the diagnostic and prognostic value of GDF-15 in different settings in cardiology.
Collapse
Affiliation(s)
- Bruna Miers May
- Universidade Federal do Rio Grande do SulPrograma de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências CardiovascularesPorto AlegreRSBrasil Universidade Federal do Rio Grande do Sul
-
Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares
,
Porto Alegre
,
RS
-
Brasil
| | - Mauricio Pimentel
- Hospital de Clinicas de Porto AlegreHospital de Clinicas de Porto AlegrePorto AlegreRSBrasil Hospital de Clinicas de Porto Alegre
,
Porto Alegre
,
RS
-
Brasil
| | - Leandro Ioschpe Zimerman
- Hospital de Clinicas de Porto AlegreHospital de Clinicas de Porto AlegrePorto AlegreRSBrasil Hospital de Clinicas de Porto Alegre
,
Porto Alegre
,
RS
-
Brasil
| | - Luis Eduardo Rohde
- Hospital de Clinicas de Porto AlegreHospital de Clinicas de Porto AlegrePorto AlegreRSBrasil Hospital de Clinicas de Porto Alegre
,
Porto Alegre
,
RS
-
Brasil
| |
Collapse
|
16
|
Trippel TD, Mende M, Düngen HD, Hashemi D, Petutschnigg J, Nolte K, Herrmann-Lingen C, Binder L, Hasenfuss G, Pieske B, Wachter R, Edelmann F. The diagnostic and prognostic value of galectin-3 in patients at risk for heart failure with preserved ejection fraction: results from the DIAST-CHF study. ESC Heart Fail 2021; 8:829-841. [PMID: 33566456 PMCID: PMC8006663 DOI: 10.1002/ehf2.13174] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 01/30/2023] Open
Abstract
Aims Galectin‐3 (Gal‐3) predicts long‐term outcome among patients with heart failure (HF) with preserved ejection fraction (HFpEF). The ability of Gal‐3 to diagnose and predict incident HFpEF in a cohort at risk for HFpEF is of particular interest. We aimed to determine the association between Gal‐3 and clinical manifestations of HFpEF, the relationship between Gal‐3 and all‐cause mortality, or the composite of cardiovascular hospitalization and death. Methods and results The observational Diast‐CHF study included patients aged 50 to 85 years with ≥1 risk factor for HF (e.g. hypertension, diabetes mellitus, and atherosclerotic disease) or previously suspected HF. Patients were followed for 10 years. The association between Gal‐3, evidence of diastolic dysfunction, and Framingham criteria for HF was examined. All deaths and hospitalizations were adjudicated as cardiovascular or non‐cardiovascular. The analysis population was composed of 1386 subjects (67 years old, 50.9% female). The area under the receiver operating characteristic curve to diagnose HFpEF was 0.71. At a cut‐off value of 13.57 ng/mL, sensitivity was 0.61 and specificity was 0.73 for Gal‐3, and the diagnostic power to detect HFpEF was superior to N‐terminal pro‐brain natriuretic peptide (area under the receiver operating characteristic curve 0.59, P > 0.001). Baseline Gal‐3 was associated with risk factors for HF (P < 0.001). Higher levels of Gal‐3 predicted incident HFpEF (P < 0.05), adjusted all‐cause mortality (P < 0.001), and the adjusted composite of cardiovascular hospitalization and death (P < 0.001), both independent from N‐terminal pro‐brain natriuretic peptide. Conclusions Gal‐3 differentiated patients with HFpEF from an overall cohort of well‐characterized patients with risk factors for HFpEF. Independent of other factors, baseline Gal‐3 levels were associated with a higher risk for incident HFpEF, mortality, or the composite of cardiovascular hospitalization and death over 10 year follow‐up. In conjunction with clinical parameters, Gal‐3 adds a statistically significant value for the diagnosis of HFpEF within this study, yet the clinical relevance remains debatable.
Collapse
Affiliation(s)
- Tobias Daniel Trippel
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Meinhard Mende
- Clinical Trial Centre (KKS) and Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Djawid Hashemi
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Johannes Petutschnigg
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Kathleen Nolte
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Lutz Binder
- DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Department of Clinical Chemistry, University of Göttingen Medical Centre, Göttingen, Germany
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Department of Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Rolf Wachter
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Frank Edelmann
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
17
|
Sabirzyanova AA, Galyavich AS, Baleeva LV, Galeeva ZM. [Level of the growth differentiation factor-15 in patients with acute myocardial infarction]. ACTA ACUST UNITED AC 2020; 60:1251. [PMID: 33487149 DOI: 10.18087/cardio.2020.11.n1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 11/18/2022]
Abstract
Aim To reveal relationships between growth differentiation factor-15 (GDF-15) and laboratory and instrumental indexes in patients with myocardial infarction in acute phase.Material and methods The study included 118 patients younger than 70 years with ST-segment elevation or non-ST segment elevation myocardial infarction (MI). For these patients, GDF-15 was measured by enzyme immunoassay within 48 h of MI clinical onset along with a routine examination. Statistical significance of differences in qualitative variables was assessed by the Student's t-test for normal distribution and by the nonparametric Mann-Whitney U-test; significance of differences in quantitative variables was assessed by the Pearson's chi-squared test. The presence of a relationship between quantitative variables was assessed with the Pearson's correlation coefficient and the Spearman's rank correlation coefficient.Results For patients with MI, mean GDF-15 concentration was 2.25±1.0 ng/ml. Moderate correlations were found for GDF-15 and levels of natriuretic peptide (r=0.36, p<0.01), white blood cells (r=0.32, p<0.01), and ejection fraction (Simpson rule) (r=-0.32, p<0.01); weak correlations were found with levels of troponin I (r=0.21, p=0.02) and urea (r=0.20, p=0.04), and interventricular septal thickness by echocardiography (r= -0.26, p<0.01). GDF-15 was higher in patients with ST-segment elevation MI (2.36±1.02 vs 1.99±0.96, p<0.05) and in the presence of hypo- or akinetic areas (2.35±1.05 vs 1.85±0.70, p<0.05). No dependence of GDF-15 on the presence of traditional cardiovascular risk factors was observed.Conclusion GDF-15 correlates with major markers of myocardial injury; its level is higher in patients with ST-segment elevation MI regardless of the infarct location.
Collapse
Affiliation(s)
| | | | - L V Baleeva
- Kazan State Medical University, Kazan, Russia
| | - Z M Galeeva
- Kazan State Medical University, Kazan, Russia
| |
Collapse
|
18
|
Mendez Fernandez AB, Ferrero-Gregori A, Garcia-Osuna A, Mirabet-Perez S, Pirla-Buxo MJ, Cinca-Cuscullola J, Ordonez-Llanos J, Roig Minguell E. Growth differentiation factor 15 as mortality predictor in heart failure patients with non-reduced ejection fraction. ESC Heart Fail 2020; 7:2223-2229. [PMID: 32589369 PMCID: PMC7524215 DOI: 10.1002/ehf2.12621] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/04/2019] [Accepted: 01/03/2020] [Indexed: 12/28/2022] Open
Abstract
Aims The prognostic value of biomarkers in patients with heart failure (HF) and mid‐range (HFmrEF) or preserved ejection fraction (HFpEF) has not been widely addressed. The aim of this study was to assess whether the prognostic value of growth differentiation factor 15 (GDF‐15) is superior to that of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) in patients with HFmrEF or HFpEF. Methods and results Heart failure patients with either HFpEF or HFmrEF were included in the study. During their first visit to the HF unit, serum samples were obtained and stored for later assessment of GDF‐15 and NT‐proBNP concentrations. Patients were followed up by the HF unit. The main endpoint was all‐cause mortality. A total of 311 patients, 90 (29%) HFmrEF and 221 (71%) HFpEF, were included. Mean age was 72 ± 13 years, and 136 (44%) were women. No differences were found in GDF‐15 or NT‐proBNP concentrations between both HF groups. During a median follow‐up of 15 months (Q1–Q3: 9–30 months), 98 patients (32%) died, most (71%) of cardiovascular causes. Patients who died had higher median concentrations of GDF‐15 (4085 vs. 2270 ng/L, P < 0.0001) and NT‐proBNP (1984 vs. 1095 ng/L, P < 0.0001). A Cox multivariable model identified New York Heart Association Functional Class III (P = 0.04), systolic blood pressure (P = 0.01), left atrial diameter (P = 0.03), age >65 years (P < 0.0001), and GDF‐15 concentrations (P = 0.01) but not NT‐proBNP as independent predictors of all‐cause mortality. The area under the curve was 0.797 for the basic model including NT‐proBNP, and the area under the curve comparing the overall model was 0.819, P = 0.016 (DeLong's test). Integrated discrimination improvement index after the inclusion of GDF‐15 in the model with the mortality risk factors was 0.033; that is, the ability to predict death increased by 3.3% (P = 0.004). Net reclassification improvement was 0.548 (P < 0.001); that is, the capacity to improve the classification of the event (mortality) was 54.8%. GDF‐15 concentrations were divided in tertiles (<1625, 1625–4330, and >4330 ng/L), and survival curves were evaluated using the Kaplan–Meier technique. Patients in the highest tertile had the poorest 5 year survival, at 16%, whereas the lowest tertile had the best survival, of 78% (P < 0.001). Conclusions Growth differentiation factor 15 was superior to NT‐proBNP for assessing prognosis in patients with HFpEF and HFmrEF. GDF‐15 emerges as a strong, independent biomarker for identifying HFmrEF and HFpEF patients with worse prognosis.
Collapse
Affiliation(s)
| | | | | | - Sonia Mirabet-Perez
- Department of Cardiology, CIBERCV, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Jordi Ordonez-Llanos
- Department of Biochemistry, IIB-Sant Pau, Barcelona, Spain.,Department of Biochemistry and Molecular Biology, Universitat Autònoma, Barcelona, Spain
| | | |
Collapse
|
19
|
Sarkar S, Legere S, Haidl I, Marshall J, MacLeod JB, Aguiar C, Lutchmedial S, Hassan A, Brunt KR, Kienesberger P, Pulinilkunnil T, Légaré JF. Serum GDF15, a Promising Biomarker in Obese Patients Undergoing Heart Surgery. Front Cardiovasc Med 2020; 7:103. [PMID: 32671100 PMCID: PMC7327098 DOI: 10.3389/fcvm.2020.00103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Obesity is a risk factor that negatively impacts outcomes in patients undergoing heart surgery by mechanisms that are not well-defined nor predicated on BMI alone. This knowledge gap has fuelled a search for biomarkers associated with cardiovascular diseases that could provide clinical insight to surgeons. One such biomarker is growth differentiation factor15(GDF15), associated with inflammation, metabolism, and heart failure outcomes but not yet examined in the context of obesity and cardiac surgery outcomes. Methods: Patients undergoing open-heart surgery were consented and enrolled for blood and tissue (atria) sampling at the time of surgery. Biomarker analysis was carried out using ELISA and western blot/qPCR, respectively. Biomarker screening was classified by inflammation(NLR, GDF15, Galectin3, ST2, TNFR2), heart failure(HF)/remodeling(NT-proBNP) and metabolism(glycemia, lipid profile). Patients were categorized based on BMI: obese group (BMI ≥30.0) and non-obese group(BMI 20.0–29.9). Subsequent stratification of GDF15 high patients was conservatively set as being in the 75th percentile. Results: A total of 80 patients undergoing any open-heart surgical interventions were included in the study. Obese (mean BMI = 35.8, n = 38) and non-obese (mean BMI = 25.7, n = 42) groups had no significant differences in age, sex, or co-morbidities. Compared to other biomarkers, plasma GDF15 (mean 1,736 vs. 1,207 ng/l, p < 0.001) was significantly higher in obese patients compared to non-obese. Plasma GDF15 also displayed a significant linear correlation with BMI (R2 = 0.097; p = 0.0049). Atria tissue was shown to be a significant source of GDF15 protein and tissue levels significantly correlated with plasma GDF15 (R2 = 0.4, p = 0.0004). Obesity was not associated with early/late mortality at median follow-up >2years. However, patients with high GDF15 (>1,580 ng/l) had reduced survival (65%) compared to the remaining patients with lower GDF15 levels (95%) by Kaplan Meier Analysis (median >2 years; p = 0.007). Conclusions: Circulating GDF15 is a salient biomarker likely sourced from heart tissue that appears to predict higher risk obese patients for adverse outcomes. More importantly, elevated GDF15 accounted for more sensitive outcome association than BMI at 2 years post-cardiac surgery, suggesting it heralds links to pathogenicity and should be actively studied prospectively and dynamically in a post-operative follow-up. Trial number: NCT03248921.
Collapse
Affiliation(s)
- Shreya Sarkar
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Stephanie Legere
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Ian Haidl
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Jean Marshall
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | | | - Christie Aguiar
- New Brunswick Heart Centre, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Sohrab Lutchmedial
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Ansar Hassan
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Keith R Brunt
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Petra Kienesberger
- Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Biochemistry, Dalhousie University, Halifax, NS, Canada
| | - Thomas Pulinilkunnil
- Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Biochemistry, Dalhousie University, Halifax, NS, Canada
| | - Jean-François Légaré
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| |
Collapse
|
20
|
Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers. DISEASE MARKERS 2020; 2020:1215802. [PMID: 32626540 PMCID: PMC7306098 DOI: 10.1155/2020/1215802] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 01/06/2020] [Accepted: 05/22/2020] [Indexed: 12/15/2022]
Abstract
The prevalence of heart failure (HF) due to cardiac remodelling after acute myocardial infarction (AMI) does not decrease regardless of implementation of new technologies supporting opening culprit coronary artery and solving of ischemia-relating stenosis with primary percutaneous coronary intervention (PCI). Numerous studies have examined the diagnostic and prognostic potencies of circulating cardiac biomarkers in acute coronary syndrome/AMI and heart failure after AMI, and even fewer have depicted the utility of biomarkers in AMI patients undergoing primary PCI. Although complete revascularization at early period of acute coronary syndrome/AMI is an established factor for improved short-term and long-term prognosis and lowered risk of cardiovascular (CV) complications, late adverse cardiac remodelling may be a major risk factor for one-year mortality and postponded heart failure manifestation after PCI with subsequent blood flow resolving in culprit coronary artery. The aim of the review was to focus an attention on circulating biomarker as a promising tool to stratify AMI patients at high risk of poor cardiac recovery and developing HF after successful PCI. The main consideration affects biomarkers of inflammation, biomechanical myocardial stress, cardiac injury and necrosis, fibrosis, endothelial dysfunction, and vascular reparation. Clinical utilities and predictive modalities of natriuretic peptides, cardiac troponins, galectin 3, soluble suppressor tumorogenicity-2, high-sensitive C-reactive protein, growth differential factor-15, midregional proadrenomedullin, noncoding RNAs, and other biomarkers for adverse cardiac remodelling are discussed in the review.
Collapse
|
21
|
The utility of growth differentiation factor-15, galectin-3, and sST2 as biomarkers for the diagnosis of heart failure with preserved ejection fraction and compared to heart failure with reduced ejection fraction: a systematic review. Heart Fail Rev 2020; 26:799-812. [PMID: 32472523 DOI: 10.1007/s10741-020-09913-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The objective was to evaluate the diagnosis of heart failure with preserved ejection fraction (HFpEF) using the biomarkers, growth differentiation factor-15 (GDF-15), galectin-3 (Gal-3), and soluble ST2 (sST2), and to determine whether they can differentiate HFpEF from heart failure with reduced ejection fraction (HFrEF). Medline and Embase databases were searched with the terms diastolic heart failure or HFpEF, biomarkers, and diagnosis, limited to years 2000 to 2019. There were significantly and consistently higher levels of GDF-15, Gal-3, and sST2 in HFpEF compared to no heart failure. Importantly, the magnitude of the increase in GDF-15 or Gal-3 and possibly sST2,correlated with a greater degree of diastolic dysfunction. There were no significant differences between GDF-15, Gal-3, and sST2 in patients with HFpEF vs HFrEF. In the studies assessing these three biomarkers, BNP was significantly greater in heart failure than controls. Furthermore, BNP was significantly higher in HFrEF compared to HFpEF. The diagnostic utility of GDF-15, Gal-3, and sST2 compared to BNP was evaluated by comparing ROC curves. The data supports the contention that to distinguish HFpEF from HFrEF, an index is needed that incorporates GDF-15, Gal-3, or sST2 as well as BNP. The three biomarkers GDF-15, Gal-3, or sST2 can identify patients with HFpEF compared to individuals without heart failure but cannot differentiate HFpEF from HFrEF. BNP is higher in and is better at differentiating HFrEF from HFpEF. Indices that incorporate GDF-15, Gal-3, or sST2 as well as BNP show promise in differentiating HFpEF from HFrEF.
Collapse
|
22
|
Vlachou M, Kamperidis V, Giannakoulas G, Karamitsos T, Vlachaki E, Karvounis H. Biochemical and imaging markers in patients with thalassaemia. Hellenic J Cardiol 2020; 62:4-12. [PMID: 32387594 DOI: 10.1016/j.hjc.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/06/2020] [Accepted: 04/15/2020] [Indexed: 11/15/2022] Open
Abstract
Beta-thalassaemia is a genetic disease with different clinical aspects, which can lead to heart failure with a multifactorial mechanism. Over the last years, growing interest has been reported for biomarkers that may help in the diagnosis, staging and prognosis of heart disease at an early stage, in patients with beta-thalassaemia. This review will highlight the current clinical value of cardiac biomarkers in patients with beta-thalassaemia and the ongoing research for a possible expanded future use.
Collapse
Affiliation(s)
- Maria Vlachou
- 1(st) Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Vasileios Kamperidis
- 1(st) Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.
| | - George Giannakoulas
- 1(st) Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Theodoros Karamitsos
- 1(st) Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Efthymia Vlachaki
- Thalassaemia Unit, Ippokratio University Hospital, Thessaloniki, Greece
| | - Haralambos Karvounis
- 1(st) Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| |
Collapse
|
23
|
Growth differentiation factor-15 combined with N-terminal prohormone of brain natriuretic peptide increase 1-year prognosis prediction value for patients with acute heart failure: a prospective cohort study. Chin Med J (Engl) 2020; 132:2278-2285. [PMID: 31567379 PMCID: PMC6819038 DOI: 10.1097/cm9.0000000000000449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Clinical assessment and treatment guidance for heart failure depends on a variety of biomarkers. The objective of this study was to investigate the prognostic predictive value of growth differentiation factor-15 (GDF-15) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in assessing hospitalized patients with acute heart failure (AHF). METHODS In total, 260 patients who were admitted for AHF in the First Affiliated Hospital of Nanjing Medical University were enrolled from April 2012 to May 2016. Medical history and blood samples were collected within 24 h after the admission. The primary endpoint was the all-cause mortality within 1 year. The patients were divided into survival group and death group based on the endpoint. With established mortality risk factors and serum GDF-15 level, receiver-operator characteristic (ROC) analyses were performed. Cox regression analyses were used to further analyze the combination values of NT-proBNP and GDF-15. RESULTS Baseline GDF-15 and NT-proBNP were significantly higher amongst deceased than those in survivors (P < 0.001). In ROC analyses, area under curve (AUC) for GDF-15 to predict 1-year mortality was 0.707 (95% confidence interval [CI]: 0.648-0.762, P < 0.001), and for NT-proBNP was 0.682 (95% CI: 0.622-0.738, P < 0.001). No statistically significant difference was found between the two markers (P = 0.650). Based on the optimal cut-offs (GDF-15: 4526.0 ng/L; NT-proBNP: 1978.0 ng/L), the combination of GDF-15 and NT-proBNP increased AUC for 1-year mortality prediction (AUC = 0.743, 95% CI: 0.685-0.795, P < 0.001). CONCLUSIONS GDF-15, as a prognostic marker in patients with AHF, is not inferior to NT-proBNP. Combining the two markers could provide an early recognition of high-risk patients and improve the prediction values of AHF long-term prognosis. CLINICAL TRIAL REGISTRATION ChiCTR-ONC-12001944, http://www.chictr.org.cn.
Collapse
|
24
|
Zhang X, Karunathilaka N, Senanayake S, Subramaniam VN, Chan W, Kostner K, Fraser J, Atherton JJ, Punyadeera C. The potential prognostic utility of salivary galectin-3 concentrations in heart failure. Clin Res Cardiol 2019; 109:685-692. [PMID: 31598750 DOI: 10.1007/s00392-019-01557-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/24/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Patients with HF are at a higher risk of rehospitalisation and, as such, significant costs to our healthcare system. A non-invasive method to collect body fluids and measure Gal-3 could improve the current management of HF. In this study, we investigated the potential prognostic utility of salivary Galectin-3 (Gal-3) in patients with heart failure (HF). METHODS We collected saliva samples from patients with HF (n = 105) either at hospital discharge or during routine clinical visits. Gal-3 concentrations in saliva samples were measured by ELISA. The Kaplan-Meier survival curve analysis and Cox proportional regression model were used to determine the potential prognostic utility of salivary Gal-3 concentrations. RESULTS The primary end point was either cardiovascular death or hospitalisation. Salivary Gal-3 concentrations were significantly higher (p < 0.05) in patients with HF who subsequently experienced the primary endpoint compared to those who did not. HF patients with salivary Gal-3 concentrations > 172.58 ng/mL had a significantly (p < 0.05) higher cumulative risk of the primary endpoint compared to those with lower salivary Gal-3 concentrations. In patients with HF, salivary Gal-3 concentration was a predictor of the primary endpoint even after adjusting for other covariates. CONCLUSIONS In our pilot study, HF patients with salivary Gal-3 concentrations of > 172.58 ng/mL demonstrated a higher cumulative risk of the primary outcome compared to those with lower Gal-3 levels, even after adjusting for other variables. Confirming our findings in a larger multi-centre clinical trial in the future would enable salivary Gal-3 measurements to form part of routine management for patients with HF.
Collapse
Affiliation(s)
- Xi Zhang
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4001, Australia
| | - Nuwan Karunathilaka
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4001, Australia
| | - Sameera Senanayake
- Australian Centre For Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - V Nathan Subramaniam
- School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Wandy Chan
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Karam Kostner
- Department of Cardiology, Mater Adult Hospital, Brisbane, QLD, Australia
| | - John Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - John J Atherton
- Cardiology Department, Royal Brisbane and Women's Hospital and University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4001, Australia.
| |
Collapse
|
25
|
Desmedt S, Desmedt V, De Vos L, Delanghe JR, Speeckaert R, Speeckaert MM. Growth differentiation factor 15: A novel biomarker with high clinical potential. Crit Rev Clin Lab Sci 2019; 56:333-350. [DOI: 10.1080/10408363.2019.1615034] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | - Valérie Desmedt
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Leen De Vos
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | | | | | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| |
Collapse
|
26
|
Grote Beverborg N, Klip IJT, Meijers WC, Voors AA, Vegter EL, van der Wal HH, Swinkels DW, van Pelt J, Mulder AB, Bulstra SK, Vellenga E, Mariani MA, de Boer RA, van Veldhuisen DJ, van der Meer P. Definition of Iron Deficiency Based on the Gold Standard of Bone Marrow Iron Staining in Heart Failure Patients. Circ Heart Fail 2019; 11:e004519. [PMID: 29382661 DOI: 10.1161/circheartfailure.117.004519] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 12/14/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The most commonly used definition of iron deficiency (ID; ferritin <100 ng/mL or ferritin 100-300 ng/mL and transferrin saturation [TSAT] <20%) has not been validated in patients with heart failure (HF). We aimed to define and validate the biomarker-based definition of ID in HF, using bone marrow iron staining as the gold standard. Second, we aimed to assess the prognostic value of the optimized definition. METHODS AND RESULTS Bone marrow aspiration with iron staining was performed in 42 patients with HF and a reduced left ventricular ejection fraction (≤45%) undergoing median sternotomy for coronary artery bypass grafting. Patients were mostly male (76%) with mild-to-moderate HF and a mean age of 68±10 years. Bone marrow ID was found in 17 (40%) of the HF patients. The most commonly used definition of ID had a sensitivity of 82% and a specificity of 72%. A definition solely based on TSAT ≤19.8% or serum iron ≤13 µmol/L had a sensitivity of 94% and specificity of 84% and 88%, respectively (P<0.05 compared with the former definition). Subsequently, we assessed the incidence of all-cause mortality in 387 consecutive outpatient HF patients (left ventricular ejection fraction ≤45%). In these patients, TSAT ≤19.8% and serum iron ≤13 µmol/L, and not ferritin, were independently associated with mortality. CONCLUSIONS A TSAT ≤19.8% or a serum iron ≤13 µmol/L shows the best performance in selecting patients with ID and identifies HF patients at the highest risk of death. Our findings validate the currently used TSAT cutoff of <20% for the identification of ID in HF patients, but question the diagnostic value of ferritin.
Collapse
Affiliation(s)
- Niels Grote Beverborg
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - IJsbrand T Klip
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Wouter C Meijers
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Adriaan A Voors
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Eline L Vegter
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Haye H van der Wal
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Dorine W Swinkels
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Joost van Pelt
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Andre B Mulder
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Sjoerd K Bulstra
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Edo Vellenga
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Massimo A Mariani
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Rudolf A de Boer
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Dirk J van Veldhuisen
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.)
| | - Peter van der Meer
- From the Department of Cardiology (N.G.B., I.T.K., W.C.M., A.A.V., E.L.V., H.H.v.d.W., R.A.d.B., D.J.v.V., P.v.d.M.), Department of Laboratory Medicine (J.v.P.), Department of Hematology (A.B.M., E.V.), Department of Orthopedics (S.K.B.), and Department of Thoracic Surgery (M.A.M.), University Medical Center Groningen, University of Groningen, The Netherlands; and Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (D.W.S.).
| |
Collapse
|
27
|
Xie S, Lu L, Liu L. Growth differentiation factor-15 and the risk of cardiovascular diseases and all-cause mortality: A meta-analysis of prospective studies. Clin Cardiol 2019; 42:513-523. [PMID: 30697778 PMCID: PMC6523003 DOI: 10.1002/clc.23159] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/16/2019] [Accepted: 01/25/2019] [Indexed: 02/06/2023] Open
Abstract
Background and Aim Previous studies have documented that the association between growth differentiation factor‐15 (GDF‐15) the risk of patients with cardiovascular diseases (CVDs). In this meta‐analysis, our main objective is to explore the associations between GDF‐15 and the risk of CVD or all‐cause mortality. Methods PubMed and ISI Web of Science (up to January 2018) electronic databases were browsed for eligible studies. The studies provided relevant data depicted as hazard ratio (HR) with 95% confidence interval (CI), with regard to the association between GDF‐15 levels and subsequent risk of CVDs or all‐cause mortality. A random‐effect model was applied to pool the HR and 95% CI. Results Thirty‐one prospective studies met the eligibility criteria involving 53 706 subjects with 7020 adverse outcome events. It was concluded that GDF‐15 levels were associated with an incremental risk of CVDs or all‐cause mortality. Highest GDF‐15 category was associated with greater risk of cardiovascular mortality (HR, 2.66; 95% CI, 1.69‐3.63), all‐cause mortality (HR, 2.52; 95% CI, 2.06‐2.97), and complex adverse outcome (HR, 1.81; 95% CI, 1.42‐2.21). As each log‐unit increment in GDF‐15 concentration, the corresponding risk of adverse events also escalated, cardiovascular mortality (HR, 2.11; 95% CI, 1.57‐2.66), all‐cause mortality (HR, 2.70; 95% CI, 2.29‐3.12), and complex adverse outcome (HR, 1.96; 95% CI, 1.64‐2.29). Conclusions Judging from the results of the data analysis, GDF‐15 levels may increase the risk of CVDs or all‐cause mortality.
Collapse
Affiliation(s)
- Shanhui Xie
- Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liping Lu
- Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liwei Liu
- Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
28
|
Li S, Li S, Hao X, Zhang Y, Deng W. Perindopril and a Galectin-3 Inhibitor Improve Ischemic Heart Failure in Rabbits by Reducing Gal-3 Expression and Myocardial Fibrosis. Front Physiol 2019; 10:267. [PMID: 30967790 PMCID: PMC6438875 DOI: 10.3389/fphys.2019.00267] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/28/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: Ventricular remodeling is considered the basis of heart failure and is involved in myocardial fibrosis. This study aimed to assess perindopril and a galectin-3 inhibitor (modified citrus pectin, MCP) for their effects on ventricular remodeling and myocardial fibrosis in rabbits with ischemic heart failure. Methods: Rabbits were divided into sham, heart failure (model), MCP, and perindopril groups, respectively. A rabbit model of ischemic heart failure was established by ligating the anterior descending coronary artery. Then, the rabbits were orally administered MCP, perindopril, or saline (all at 2 ml/kg/d) for 4 weeks. Sham animals only underwent open heart surgery without further treatment. After 4 weeks, cardiac function was examined by ultrasound, and myocardial Gal-3, collagen type I, and collagen type III expression was assessed, at the gene and protein levels, by real-time PCR and Western-Blot, respectively; serum Gal-3 was detected by ELISA, and fibrosis in the infarct zone was evaluated by H&E and Masson staining. Results: In model animals, myocardial Gal-3, collagen type I, and collagen type III gene and protein expression levels were increased compared with control values, as well as serum Gal-3 amounts. Treatment with perindopril and MCP significantly alleviated the above effects, with no significant differences between the treatment groups. Pathological analyses showed that compared with model animals, treatment with MCP or perindopril resulted in relatively neatly arranged myocardial cells in the infarct zone, with significantly decreased fibrosis. Conclusion: Perindopril and the galectin-3 inhibitor MCP comparably improve ischemic heart failure in rabbits, by downregulating Gal-3 and reducing myocardial fibrosis.
Collapse
Affiliation(s)
- Sha Li
- Department of Examination Center, Hebei General Hospital, Shijiazhuang, China
| | - Shuren Li
- Department of Cardiovascular Division 1, Hebei General Hospital, Shijiazhuang, China
| | - Xiao Hao
- Department of Cardiovascular Division 1, Hebei General Hospital, Shijiazhuang, China
| | - Yuehua Zhang
- Department of Cardiovascular Division 1, Hebei General Hospital, Shijiazhuang, China
| | - Wenhao Deng
- Department of Cardiovascular Division 1, Hebei General Hospital, Shijiazhuang, China
| |
Collapse
|
29
|
Brankovic M, Martijn Akkerhuis K, Mouthaan H, Constantinescu A, Caliskan K, van Ramshorst J, Germans T, Umans V, Kardys I. Utility of temporal profiles of new cardio-renal and pulmonary candidate biomarkers in chronic heart failure. Int J Cardiol 2019; 276:157-165. [DOI: 10.1016/j.ijcard.2018.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/03/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023]
|
30
|
Aimo A, Januzzi JL, Vergaro G, Ripoli A, Latini R, Masson S, Magnoli M, Anand IS, Cohn JN, Tavazzi L, Tognoni G, Gravning J, Ueland T, Nymo SH, Rocca HPBL, Bayes-Genis A, Lupón J, de Boer RA, Yoshihisa A, Takeishi Y, Egstrup M, Gustafsson I, Gaggin HK, Eggers KM, Huber K, Tentzeris I, Wilson Tang WH, Grodin JL, Passino C, Emdin M. High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure. Int J Cardiol 2018; 277:166-172. [PMID: 30416028 DOI: 10.1016/j.ijcard.2018.10.079] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/28/2018] [Accepted: 10/24/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis. METHODS AND RESULTS 9289 patients (66 ± 12 years, 77% men, 85% LVEF <40%, 60% ischemic HF) were evaluated over a 2.4-year median follow-up. Median eGFR was 58 mL/min/1.73 m2 (interquartile interval 46-70; n = 9220), hs-TnT 16 ng/L (8-20; n = 9289), NT-proBNP 1067 ng/L (433-2470; n = 8845), and hs-CRP 3.3 mg/L (1.4-7.8; n = 7083). In a model including all 3 biomarkers, only hs-TnT and NT-proBNP were independent predictors of all-cause and cardiovascular mortality and cardiovascular hospitalization. hs-TnT was a stronger predictor than NT-proBNP: for example, the risk for all-cause death increased by 54% per doubling of hs-TnT vs. 24% per doubling of NT-proBNP. eGFR showed independent prognostic value from both hs-TnT and NT-proBNP. The best hs-TnT and NT-proBNP cut-offs for the prediction of all-cause death increased progressively with declining renal function (eGFR ≥ 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR < 30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes. CONCLUSIONS hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance.
Collapse
Affiliation(s)
| | - James L Januzzi
- Massachusetts General Hospital, Harvard Clinical Research Institute, Boston, MA, USA
| | - Giuseppe Vergaro
- Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy
| | | | - Roberto Latini
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy
| | - Michela Magnoli
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy
| | - Inder S Anand
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Cardiology, VA Medical Centre, Minneapolis, MN, USA
| | - Jay N Cohn
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Luigi Tavazzi
- GVM Hospitals of Care and Research, E.S. Health Science Foundation, Cotignola, Italy
| | - Gianni Tognoni
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy
| | - Jørgen Gravning
- Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway; Centre for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Thrombosis Research and Expertise Centre, University of Tromsø, Tromsø, Norway
| | - Ståle H Nymo
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | | | - Josep Lupón
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Michael Egstrup
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Ida Gustafsson
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Hanna K Gaggin
- Massachusetts General Hospital, Harvard Clinical Research Institute, Boston, MA, USA
| | - Kai M Eggers
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Kurt Huber
- Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria
| | - Ioannis Tentzeris
- Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria
| | - W H Wilson Tang
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Justin L Grodin
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Centre, Dallas, TX, USA
| | - Claudio Passino
- Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Michele Emdin
- Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy
| |
Collapse
|
31
|
Management of Heart Failure in Adult Congenital Heart Disease. Prog Cardiovasc Dis 2018; 61:308-313. [DOI: 10.1016/j.pcad.2018.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/09/2018] [Indexed: 12/14/2022]
|
32
|
Bettencourt P, Ferreira-Coimbra J, Rodrigues P, Marques P, Moreira H, Pinto MJ, Guimarães JT, Lourenço P. Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15. ESC Heart Fail 2018; 5:1017-1022. [PMID: 30144302 PMCID: PMC6301153 DOI: 10.1002/ehf2.12301] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 02/22/2018] [Accepted: 04/08/2018] [Indexed: 01/05/2023] Open
Abstract
Aims Growth differentiation factor (GDF)‐15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF‐15 and BNP in acute HF. Methods and results We studied a subgroup of patients prospectively recruited in an acute HF registry (follow‐up: 2 years; endpoint: all‐cause mortality). Cox regression multivariate models were built to study the association of GDF‐15 and mortality. Further cross‐classification according to discharge GDF‐15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy‐nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF‐15 was 3013 ng/mL. Higher BNP and GDF‐15 predicted 2‐year mortality. Patients with GDF‐15 ≥ 3000 ng/mL had a multivariate adjusted 2‐year death risk of 1.86 (1.08–3.18). Patients discharged with both BNP and GDF‐15 above the mean had an adjusted hazard ratio of 4.33 (2.07–9.06) when compared with those with both <mean. Conclusions Higher GDF‐15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF‐15 and BNP were elevated at discharge, the 2‐year mortality risk increased over four‐fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.
Collapse
Affiliation(s)
- Paulo Bettencourt
- Faculty of Medicine, University of Porto, Porto, Portugal.,Internal Medicine Department, Hospital CUF, Porto, Portugal
| | | | - Pedro Rodrigues
- Internal Medicine Department, São João Hospital Center, Porto, Portugal
| | - Pedo Marques
- Internal Medicine Department, São João Hospital Center, Porto, Portugal
| | - Helena Moreira
- Internal Medicine Department, São João Hospital Center, Porto, Portugal
| | - Maria João Pinto
- Faculty of Medicine, University of Porto, Porto, Portugal.,Clinical Pathology Department, São João Hospital Center, Porto, Portugal
| | - João Tiago Guimarães
- Faculty of Medicine, University of Porto, Porto, Portugal.,Clinical Pathology Department, São João Hospital Center, Porto, Portugal
| | - Patrícia Lourenço
- Faculty of Medicine, University of Porto, Porto, Portugal.,Internal Medicine Department, São João Hospital Center, Porto, Portugal
| |
Collapse
|
33
|
Simpson J, McMurray JJV. Prognostic Modeling in Heart Failure: Time for a Reboot. JACC-HEART FAILURE 2018; 6:463-464. [PMID: 29852930 DOI: 10.1016/j.jchf.2018.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Joanne Simpson
- British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - John J V McMurray
- British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
| |
Collapse
|
34
|
Growth differentiation factor-15 is a new biomarker for survival and renal outcomes in light chain amyloidosis. Blood 2018; 131:1568-1575. [DOI: 10.1182/blood-2017-12-819904] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 01/18/2018] [Indexed: 11/20/2022] Open
Abstract
Key Points
GDF-15 level is a new prognostic factor for survival in AL amyloidosis, and its reduction after therapy is associated with better outcome. GDF-15 level is probably the strongest predictor for renal outcomes in patients with AL amyloidosis.
Collapse
|
35
|
Ovchinnikova E, Hoes M, Ustyantsev K, Bomer N, de Jong TV, van der Mei H, Berezikov E, van der Meer P. Modeling Human Cardiac Hypertrophy in Stem Cell-Derived Cardiomyocytes. Stem Cell Reports 2018; 10:794-807. [PMID: 29456183 PMCID: PMC5918264 DOI: 10.1016/j.stemcr.2018.01.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 12/17/2022] Open
Abstract
Cardiac hypertrophy accompanies many forms of cardiovascular diseases. The mechanisms behind the development and regulation of cardiac hypertrophy in the human setting are poorly understood, which can be partially attributed to the lack of a human cardiomyocyte-based preclinical test system recapitulating features of diseased myocardium. The objective of our study is to determine whether human embryonic stem cell-derived cardiomyocytes (hESC-CMs) subjected to mechanical stretch can be used as an adequate in vitro model for studying molecular mechanisms of cardiac hypertrophy. We show that hESC-CMs subjected to cyclic stretch, which mimics mechanical overload, exhibit essential features of a hypertrophic state on structural, functional, and gene expression levels. The presented hESC-CM stretch approach provides insight into molecular mechanisms behind mechanotransduction and cardiac hypertrophy and lays groundwork for the development of pharmacological approaches as well as for discovering potential circulating biomarkers of cardiac dysfunction.
Collapse
Affiliation(s)
- Ekaterina Ovchinnikova
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, the Netherlands; European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan, 1, PO Box 196, Groningen, the Netherlands
| | - Martijn Hoes
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, the Netherlands
| | - Kirill Ustyantsev
- Laboratory of Molecular Genetic Systems, Institute of Cytology and Genetics, Novosibirsk, 630090, Russia
| | - Nils Bomer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, the Netherlands
| | - Tristan V de Jong
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan, 1, PO Box 196, Groningen, the Netherlands
| | - Henny van der Mei
- University of Groningen, University Medical Center Groningen, Biomedical Engineering Department, Groningen, 9713AV, the Netherlands
| | - Eugene Berezikov
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan, 1, PO Box 196, Groningen, the Netherlands.
| | - Peter van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, the Netherlands.
| |
Collapse
|
36
|
Aimo A, Januzzi JL, Vergaro G, Ripoli A, Latini R, Masson S, Magnoli M, Anand IS, Cohn JN, Tavazzi L, Tognoni G, Gravning J, Ueland T, Nymo SH, Brunner-La Rocca HP, Genis AB, Lupón J, de Boer RA, Yoshihisa A, Takeishi Y, Egstrup M, Gustafsson I, Gaggin HK, Eggers KM, Huber K, Tentzeris I, Tang WH, Grodin J, Passino C, Emdin M. Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure. Circulation 2018; 137:286-297. [DOI: 10.1161/circulationaha.117.031560] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023]
Abstract
Background:
Most patients with chronic heart failure have detectable troponin concentrations when evaluated by high-sensitivity assays. The prognostic relevance of this finding has not been clearly established so far. We aimed to assess high-sensitivity troponin assay for risk stratification in chronic heart failure through a meta-analysis approach.
Methods:
Medline, EMBASE, Cochrane Library, and Scopus were searched in April 2017 by 2 independent authors. The terms were “troponin” AND “heart failure” OR “cardiac failure” OR “cardiac dysfunction” OR “cardiac insufficiency” OR “left ventricular dysfunction.” Inclusion criteria were English language, clinical stability, use of a high-sensitivity troponin assay, follow-up studies, and availability of individual patient data after request to authors. Data retrieved from articles and provided by authors were used in agreement with the PRISMA statement. The end points were all-cause death, cardiovascular death, and hospitalization for cardiovascular cause.
Results:
Ten studies were included, reporting data on 11 cohorts and 9289 patients (age 66±12 years, 77% men, 60% ischemic heart failure, 85% with left ventricular ejection fraction <40%). High-sensitivity troponin T data were available for all patients, whereas only 209 patients also had high-sensitivity troponin I assayed. When added to a prognostic model including established risk markers (sex, age, ischemic versus nonischemic etiology, left ventricular ejection fraction, estimated glomerular filtration rate, and N-terminal fraction of pro-B-type natriuretic peptide), high-sensitivity troponin T remained independently associated with all-cause mortality (hazard ratio, 1.48; 95% confidence interval, 1.41–1.55), cardiovascular mortality (hazard ratio, 1.40; 95% confidence interval, 1.33–1.48), and cardiovascular hospitalization (hazard ratio, 1.42; 95% confidence interval, 1.36–1.49), over a median 2.4-year follow-up (all
P
<0.001). High-sensitivity troponin T significantly improved risk prediction when added to a prognostic model including the variables above. It also displayed an independent prognostic value for all outcomes in almost all population subgroups. The area under the curve–derived 18 ng/L cutoff yielded independent prognostic value for the 3 end points in both men and women, patients with either ischemic or nonischemic etiology, and across categories of renal dysfunction.
Conclusions:
In chronic heart failure, high-sensitivity troponin T is a strong and independent predictor of all-cause and cardiovascular mortality, and of hospitalization for cardiovascular causes, as well. This biomarker then represents an additional tool for prognostic stratification.
Collapse
Affiliation(s)
- Alberto Aimo
- Scuola Superiore Sant’Anna, Pisa, Italy (A.A., G.V., C.P., M.E.)
| | - James L. Januzzi
- Massachusetts General Hospital and Harvard Clinical Research Institute, Boston (J.L.J., H.K.G.)
| | - Giuseppe Vergaro
- Scuola Superiore Sant’Anna, Pisa, Italy (A.A., G.V., C.P., M.E.)
- Fondazione Toscana G. Monasterio, Pisa, Italy (G.V., A.R., C.P., M.E.)
| | - Andrea Ripoli
- Fondazione Toscana G. Monasterio, Pisa, Italy (G.V., A.R., C.P., M.E.)
| | - Roberto Latini
- Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche - “Mario Negri,” Milano, Italy (R.L., S.M., M.M., G.T.)
| | - Serge Masson
- Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche - “Mario Negri,” Milano, Italy (R.L., S.M., M.M., G.T.)
| | - Michela Magnoli
- Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche - “Mario Negri,” Milano, Italy (R.L., S.M., M.M., G.T.)
| | - Inder S. Anand
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.S.A., J.N.C.)
- Department of Cardiology, VA Medical Centre, Minneapolis, MN (I.S.A.)
| | - Jay N. Cohn
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.S.A., J.N.C.)
| | - Luigi Tavazzi
- GVM Hospitals of Care and Research, E.S. Health Science Foundation, Cotignola, Italy (L.T.)
| | - Gianni Tognoni
- Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche - “Mario Negri,” Milano, Italy (R.L., S.M., M.M., G.T.)
| | | | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Norway (T.U., S.H.N.)
- Faculty of Medicine, University of Oslo, Norway (T.U.)
- K. G. Jebsen Thrombosis Research and Expertise Centre, University of Tromsø, Norway (T.U.)
| | - Ståle H. Nymo
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Norway (T.U., S.H.N.)
| | | | - Antoni Bayes Genis
- Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain (A.B.G., J.L.)
| | - Josep Lupón
- Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain (A.B.G., J.L.)
| | | | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University, Japan (A.Y., Y.T.)
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Japan (A.Y., Y.T.)
| | - Michael Egstrup
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark (M.E., I.G.)
| | - Ida Gustafsson
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark (M.E., I.G.)
| | - Hanna K. Gaggin
- Massachusetts General Hospital and Harvard Clinical Research Institute, Boston (J.L.J., H.K.G.)
| | - Kai M. Eggers
- Department of Medical Sciences, Cardiology, Uppsala University, Sweden (K.M.E.)
| | - Kurt Huber
- Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria (K.H., I.T.)
| | - Ioannis Tentzeris
- Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria (K.H., I.T.)
| | - Wai H.W. Tang
- Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)
| | - Justin Grodin
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (J.G.)
- Centre for Heart Failure Research, University of Oslo, Norway (J.G.)
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (J.G.)
| | - Claudio Passino
- Scuola Superiore Sant’Anna, Pisa, Italy (A.A., G.V., C.P., M.E.)
- Fondazione Toscana G. Monasterio, Pisa, Italy (G.V., A.R., C.P., M.E.)
| | - Michele Emdin
- Scuola Superiore Sant’Anna, Pisa, Italy (A.A., G.V., C.P., M.E.)
- Fondazione Toscana G. Monasterio, Pisa, Italy (G.V., A.R., C.P., M.E.)
| |
Collapse
|
37
|
van Vark LC, Lesman-Leegte I, Baart SJ, Postmus D, Pinto YM, de Boer RA, Asselbergs FW, Wajon EMCJ, Orsel JG, Boersma E, Hillege HL, Akkerhuis KM. Prognostic Value of Serial Galectin-3 Measurements in Patients With Acute Heart Failure. J Am Heart Assoc 2017; 6:JAHA.116.003700. [PMID: 29187387 PMCID: PMC5778986 DOI: 10.1161/jaha.116.003700] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several clinical studies have evaluated the association between galectin-3 levels and outcome in patients with heart failure (HF). However, little is known about the predictive value of repeated galectin-3 measurements. This study evaluates the prognostic value of repeated time-dependent galectin-3 measurements in acute HF patients. METHODS AND RESULTS In the TRIUMPH (Translational Initiative on Unique and Novel Strategies for Management of Patients with Heart Failure) clinical cohort study, 496 acute HF patients were enrolled in 14 hospitals in The Netherlands, between 2009 and 2014. Repeated blood samples (7) were drawn during 1-year follow-up. Associations between repeated biomarker measurements and the primary end point were assessed using a joint model. Median age was 74 years and 37% were women. The primary end point, composite of all-cause mortality and HF rehospitalization, was reached in 188 patients (40%), during a median follow-up of 325 days (interquartile range 85-401). The median baseline galectin-3 level was 24 ng/mL (interquartile range 18-34). The mean number of galectin-3 measurements available per patient was 4.3. After adjustment for clinical factors and N-terminal pro-brain natriuretic peptide, there was a weak association between baseline galectin-3 and risk of the primary end point. When repeated measurements were taken into account, the adjusted hazard ratio per 1 SD increase of the galectin-3 level (on the log2 scale) at any time point increased to 1.67 (95% confidence interval, 1.24-2.23, P<0.001). After additional adjustment for repeated N-terminal pro-brain natriuretic peptide measurements, the association remained statistically significant. CONCLUSIONS Repeated galectin-3 measurements appeared to be a strong predictor of outcome in acute HF patients, independent of N-terminal pro-brain natriuretic peptide. Hence, galectin-3 may be helpful in clinical practice for prognostication and treatment monitoring.
Collapse
Affiliation(s)
- Laura C van Vark
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands .,Cardiovascular Research School Erasmus MC (COEUR), Rotterdam, The Netherlands
| | - Ivonne Lesman-Leegte
- Department of Epidemiology, University Medical Center Groningen University of Groningen, The Netherlands
| | - Sara J Baart
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.,Cardiovascular Research School Erasmus MC (COEUR), Rotterdam, The Netherlands
| | - Douwe Postmus
- Department of Epidemiology, University Medical Center Groningen University of Groningen, The Netherlands
| | - Yigal M Pinto
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherland
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen University of Groningen, The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, Utrecht, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Elly M C J Wajon
- Department of Cardiology, Medical Spectrum Twente, Enschede, The Netherlands
| | - Joke G Orsel
- Department of Precision and Decentralized Diagnostics, Philips Research, Eindhoven, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.,Cardiovascular Research School Erasmus MC (COEUR), Rotterdam, The Netherlands
| | - Hans L Hillege
- Department of Epidemiology, University Medical Center Groningen University of Groningen, The Netherlands
| | - K Martijn Akkerhuis
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.,Cardiovascular Research School Erasmus MC (COEUR), Rotterdam, The Netherlands
| | | |
Collapse
|
38
|
Welsh P, Kou L, Yu C, Anand I, van Veldhuisen DJ, Maggioni AP, Desai AS, Solomon SD, Pfeffer MA, Cheng S, Gullestad L, Aukrust P, Ueland T, Swedberg K, Young JB, Kattan MW, Sattar N, McMurray JJV. Prognostic importance of emerging cardiac, inflammatory, and renal biomarkers in chronic heart failure patients with reduced ejection fraction and anaemia: RED-HF study. Eur J Heart Fail 2017; 20:268-277. [PMID: 28960777 PMCID: PMC6607475 DOI: 10.1002/ejhf.988] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/04/2017] [Accepted: 08/07/2017] [Indexed: 12/28/2022] Open
Abstract
Aims To test the prognostic value of emerging biomarkers in the Reduction of Events by Darbepoetin Alfa in Heart Failure (RED‐HF) trial. Methods and results Circulating cardiac [N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), and high‐sensitivity troponin T (hsTnT)], neurohumoral [mid‐regional pro‐adrenomedullin (MR‐proADM) and copeptin], renal (cystatin C), and inflammatory [high‐sensitivity C‐reactive protein (hsCRP)] biomarkers were measured at randomization in 1853 participants with complete data. The relationship between these biomarkers and the primary composite endpoint of heart failure hospitalization or cardiovascular death over 28 months of follow‐up (n = 834) was evaluated using Cox proportional hazards regression, the c‐statistic and the net reclassification index (NRI). After adjustment, the hazard ratio (HR) for the composite outcome in the top tertile of the distribution compared to the lowest tertile for each biomarker was: NT‐proBNP 3.96 (95% CI 3.16–4.98), hsTnT 3.09 (95% CI 2.47–3.88), MR‐proADM 2.28 (95% CI 1.83–2.84), copeptin 1.66 (95% CI 1.35–2.04), cystatin C 1.92 (95% CI 1.55–2.37), and hsCRP 1.51 (95% CI 1.27–1.80). A basic clinical prediction model was improved on addition of each biomarker individually, most strongly by NT‐proBNP (NRI +62.3%, P < 0.001), but thereafter was only improved marginally by addition of hsTnT (NRI +33.1%, P = 0.004). Further addition of biomarkers did not improve discrimination further. Findings were similar for all‐cause mortality. Conclusion Once NT‐proBNP is included, only hsTnT moderately further improved risk stratification in this group of chronic heart failure with reduced ejection fraction patients with moderate anaemia. NT‐proBNP and hsTnT far outperform other emerging biomarkers in prediction of adverse outcome.
Collapse
Affiliation(s)
- Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Lei Kou
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Changhong Yu
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Inder Anand
- VA Medical Center, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Akshay S Desai
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Scott D Solomon
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc A Pfeffer
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Lars Gullestad
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pål Aukrust
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway
| | - Karl Swedberg
- University of Gothenburg, Gothenburg, Sweden, and National Heart and Lung Institute, Imperial College, London, UK
| | - James B Young
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - John J V McMurray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
39
|
Bayés-Genis A, Lanfear DE, de Ronde MWJ, Lupón J, Leenders JJ, Liu Z, Zuithoff NPA, Eijkemans MJC, Zamora E, De Antonio M, Zwinderman AH, Pinto-Sietsma SJ, Pinto YM. Prognostic value of circulating microRNAs on heart failure-related morbidity and mortality in two large diverse cohorts of general heart failure patients. Eur J Heart Fail 2017; 20:67-75. [PMID: 28949058 DOI: 10.1002/ejhf.984] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/11/2022] Open
Abstract
AIMS Small studies suggested circulating microRNAs (miRNAs) as biomarkers for heart failure (HF). However, standardized approaches and quality assessment for measuring circulating miRNAs are not uniformly established, and most studies have been small, so that results are inconsistent. We used a standardized data handling protocol, optimized for circulating miRNA qPCRs to remove noise and used it to assess which circulating miRNAs robustly add prognostic information in patients with HF. METHODS AND RESULTS We measured 12 miRNAs in two independent cohorts totalling 2203 subjects. Cohort I (Barcelona) comprised 834 chronic HF patients. Cohort II (Detroit) comprised 1369 chronic HF patients. Each sample was measured in duplicate, and normalized to a very abundant and stable miRNA (miR-486-5p). We used a multistep algorithm to distinguish false amplification signals and thus classify each miRNA measurement as 'valid', 'undetectable' or 'invalid'. Higher levels of miR-1254 and miR-1306-5p were significantly associated with risk of the combined endpoint of all-cause mortality and HF hospitalization in both cohorts, with hazard ratios ranging from 1.11 to 1.21 per log increase (P-values 0.004 to 0.009). However, adding these miRNAs to established predictors (age, sex, haemoglobin, renal function, and NT-proBNP) did not further augment the c-statistic beyond 0.69 (cohort I) or 0.70 (cohort II). CONCLUSION We used a stringent quality assessment for miRNA testing, and were able to replicate the association of miR-1254 and miR-1306-5p with risk of death and HF hospitalization in HF patients of two independent cohorts. However, these two circulating miRNAs failed to improve prognostication over established predictors.
Collapse
Affiliation(s)
- Antoni Bayés-Genis
- Heart Failure Unit, Germans Trias i Pujol Hospital, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David E Lanfear
- Henry Ford Hospital, Heart and Vascular Institute, Detroit, MI, USA
| | - Maurice W J de Ronde
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Josep Lupón
- Heart Failure Unit, Germans Trias i Pujol Hospital, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Zhen Liu
- ACS Biomarker BV, Amsterdam, The Netherlands
| | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marinus J C Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Elisabet Zamora
- Heart Failure Unit, Germans Trias i Pujol Hospital, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta De Antonio
- Heart Failure Unit, Germans Trias i Pujol Hospital, Badalona, Spain
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sara-Joan Pinto-Sietsma
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Yigal M Pinto
- ACS Biomarker BV, Amsterdam, The Netherlands.,Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
40
|
Zhang Y, Jiang W, Wang L, Lingappan K. Sex-specific differences in the modulation of Growth Differentiation Factor 15 (GDF15) by hyperoxia in vivo and in vitro: Role of Hif-1α. Toxicol Appl Pharmacol 2017; 332:8-14. [PMID: 28734801 DOI: 10.1016/j.taap.2017.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/01/2017] [Accepted: 07/18/2017] [Indexed: 12/22/2022]
Abstract
Male premature neonates are more susceptible than females to the development of bronchopulmonary dysplasia (BPD). The reasons underlying sexually dimorphic outcomes in premature neonates are not known. GDF15 (Growth and differentiation factor 15) is a secreted cytokine and plays a role in cell proliferation, apoptosis, and angiogenesis. In this study, we sought to elucidate the sex-specific expression of Gdf15 in the lung in vivo in neonatal hyperoxic lung injury and its regulation by Hif-1α, and to delineate the differences in GDF15 expression in male and female human umbilical venous endothelial cells in an in vitro model of oxygen toxicity. Following hyperoxia exposure (95% FiO2, PND (postnatal day 1-5: saccular stage of lung development), neonatal male mice (C57BL/6) show increased GDF15 and decreased HIF-1α expression compared to female mice. For the in vitro experiments, male and female HUVECs were exposed to room air condition (21% O2, 5% CO2) or in hyperoxia condition (95% O2, 5% CO2) for up to 72h. Male HUVECs had greater expression of GDF15 mRNA and protein. To study the inter-relationship between GDF15 and HIF-1α, we measured the expression of GDF15 in H441 cells after HIF-1α knockdown using promoter dual luciferase reporter assay, which showed that HIF-1α and GDF15 expression are inversely related under normoxia and hyperoxia. The results indicate that sex differences exist in the expression and modulation of GDF15 by HIF-1α in neonatal hyperoxic injury both in vivo and in vitro. These differences could explain in part the mechanisms behind sex-specific differences in BPD.
Collapse
Affiliation(s)
- Yuhao Zhang
- Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Weiwu Jiang
- Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Lihua Wang
- Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Krithika Lingappan
- Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
| |
Collapse
|
41
|
Zeng X, Li L, Wen H, Bi Q. Growth-differentiation factor 15 as a predictor of mortality in patients with heart failure: a meta-analysis. J Cardiovasc Med (Hagerstown) 2017; 18:53-59. [PMID: 27454651 DOI: 10.2459/jcm.0000000000000412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS Measurement of the biomarker growth-differentiation factor 15 (GDF-15) in patients with heart failure may help in risk stratification. We assessed the relationship between GDF-15 and mortality in patients with heart failure by conducting a meta-analysis. METHODS PubMed, Embase, ISI Web of Science, SCOPUS, and Cochrane Library databases were searched for studies that reported data on the baseline GDF-15 levels and all-cause or cardiovascular mortality. Pooled hazard ratios for mortality were calculated and presented with 95% confidence intervals (CIs). Potential sources of heterogeneity were assessed by meta-regression, subgroup, and sensitivity analyses. RESULTS Eight studies with a total of 4126 heart failure patients were included. Pooled results showed that overexpression of GDF-15 was associated with poor survival in heart failure patients (log unit GDF-15: hazard ratio = 1.86, 95% CI = 1.37-2.52). Subgroup analyses revealed similar results. However, there was evidence of heterogeneity and publication bias. The association disappeared after correction using the trim-and-fill method (log unit GDF-15: hazard ratio 1.07, 95% CI 0.80-1.42). CONCLUSION The results of this meta-analysis indicate an association of elevated GDF-15 levels with increased risk of mortality in patients with heart failure. However, the results should be interpreted with caution due to substantial heterogeneity and publication bias among the studies included in the meta-analysis.
Collapse
Affiliation(s)
- Xiaocong Zeng
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | | | | | | |
Collapse
|
42
|
Gombozhapova A, Rogovskaya Y, Shurupov V, Rebenkova M, Kzhyshkowska J, Popov SV, Karpov RS, Ryabov V. Macrophage activation and polarization in post-infarction cardiac remodeling. J Biomed Sci 2017; 24:13. [PMID: 28173864 PMCID: PMC5297120 DOI: 10.1186/s12929-017-0322-3] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/31/2017] [Indexed: 02/07/2023] Open
Abstract
Adverse cardiac remodeling leads to impaired ventricular function and heart failure, remaining a major cause of mortality and morbidity in patients with acute myocardial infarction. It have been shown that, even if all the recommended therapies for ST-segment elevation myocardial infarction are performed, one third of patients undergoes progressive cardiac remodeling that represents morphological basis for following heart failure. The need to extend our knowledge about factors leading to different clinical scenarios of myocardial infarction and following complications has resulted in a research of immuno-inflammatory pathways and molecular activities as the basis for post-infarction remodeling. Recently, macrophages (cells of the innate immune system) have become a subject of scientific interest under both normal and pathological conditions. Macrophages, besides their role in host protection and tissue homeostasis, play an important role in pathophysiological processes induced by myocardial infarction. In this article we summarize data about the function of monocytes and macrophages plasticity in myocardial infarction and outline potential role of these cells as effective targets to control processes of inflammation, cardiac remodeling and healing following acute coronary event.
Collapse
Affiliation(s)
- Aleksandra Gombozhapova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation. .,National Research Tomsk State University, 36 Lenin Avenue, 634050, Tomsk, Russian Federation.
| | - Yuliya Rogovskaya
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation.,National Research Tomsk State University, 36 Lenin Avenue, 634050, Tomsk, Russian Federation
| | - Vladimir Shurupov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation
| | - Mariya Rebenkova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation.,National Research Tomsk State University, 36 Lenin Avenue, 634050, Tomsk, Russian Federation
| | - Julia Kzhyshkowska
- National Research Tomsk State University, 36 Lenin Avenue, 634050, Tomsk, Russian Federation.,University of Heidelberg, 1-3 Theodor-Kutzer Ufer, 68167, Mannheim, Germany
| | - Sergey V Popov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation
| | - Rostislav S Karpov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation.,Siberian State Medical University, 2 Moscovsky trakt, 634055, Tomsk, Russian Federation
| | - Vyacheslav Ryabov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 111a Kievskaya Street, 634012, Tomsk, Russian Federation.,National Research Tomsk State University, 36 Lenin Avenue, 634050, Tomsk, Russian Federation.,Siberian State Medical University, 2 Moscovsky trakt, 634055, Tomsk, Russian Federation
| |
Collapse
|
43
|
Baggen VJ, van den Bosch AE, Eindhoven JA, Schut ARW, Cuypers JA, Witsenburg M, de Waart M, van Schaik RH, Zijlstra F, Boersma E, Roos-Hesselink JW. Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide, Troponin-T, and Growth-Differentiation Factor 15 in Adult Congenital Heart Disease. Circulation 2017; 135:264-279. [DOI: 10.1161/circulationaha.116.023255] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 10/19/2016] [Indexed: 01/06/2023]
Abstract
Background:
The number of patients with adult congenital heart disease (ACHD) is rapidly increasing. To optimize patient management, there is a great need to accurately identify high-risk patients. Still, no biomarker has been firmly established as a clinically useful prognostic tool in this group. We studied the association of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitive troponin-T, and growth-differentiation factor 15 with cardiovascular events in ACHD.
Methods:
Clinically stable patients with ACHD who routinely visited the outpatient clinic between April 2011 and April 2013 underwent clinical assessment, electrocardiography, echocardiography, and biomarker measurement (NT-proBNP, high-sensitive troponin-T, and growth-differentiation factor 15) at the time of study inclusion. Patients were prospectively followed for the occurrence of cardiovascular events (death, heart failure, hospitalization, arrhythmia, thromboembolic events, and reintervention). Survival curves were derived by the Kaplan-Meier method, and Cox regression was performed to investigate the relation between biomarkers and events with adjustment for multiple clinical and echocardiographic variables.
Results:
In total, 595 patients were included (median age, 33 years; interquartile range, 25–41 years; 58% male; 90% New York Heart Association class I). Patients were followed during a median of 42 (interquartile range, 37–46) months. Of the 3 evaluated biomarkers, NT-proBNP in the upper quartile (>33.3 pmol/L) was most strongly associated with cardiovascular events (n=165, adjusted hazard ratio, 9.05 [3.24–25.3],
P
<0.001) and with death or heart failure (n=50, adjusted hazard ratio, 16.0 [2.04–126],
P
<0.001). When NT-proBNP was analyzed as a continuous variable, similar findings were retrieved. The cumulative proportion of patients with death and heart failure was only 1% in the lowest 2 NT-proBNP quartiles. Elevated NT-proBNP (>14 pmol/L), elevated high-sensitive troponin-T (>14 ng/L), and elevated growth-differentiation factor 15 (>1109 ng/L) identified those patients at highest risk of cardiovascular events (log-rank
P
<0.0001).
Conclusions:
NT-proBNP provides prognostic information beyond a conventional risk marker model in patients with ACHD and can reliably exclude the risk of death and heart failure. Elevated levels of NT-proBNP, high-sensitive troponin-T, and growth-differentiation factor 15 identify patients at highest risk of cardiovascular events. These biomarkers therefore may play an important role in the monitoring and management of patients with ACHD.
Collapse
Affiliation(s)
- Vivan J.M. Baggen
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Annemien E. van den Bosch
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Jannet A. Eindhoven
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Anne-Rose W. Schut
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Judith A.A.E. Cuypers
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Maarten Witsenburg
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Monique de Waart
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Ron H.N. van Schaik
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Felix Zijlstra
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Eric Boersma
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| | - Jolien W. Roos-Hesselink
- From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.)
| |
Collapse
|
44
|
Torabi A, Cleland JGF, Sherwi N, Atkin P, Panahi H, Kilpatrick E, Thackray S, Hoye A, Alamgir F, Goode K, Rigby A, Clark AL. Influence of case definition on incidence and outcome of acute coronary syndromes. Open Heart 2016; 3:e000487. [PMID: 28123755 PMCID: PMC5237751 DOI: 10.1136/openhrt-2016-000487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/29/2016] [Accepted: 10/18/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Acute coronary syndromes (ACS) are common, but their incidence and outcome might depend greatly on how data are collected. We compared case ascertainment rates for ACS and myocardial infarction (MI) in a single institution using several different strategies. METHODS The Hull and East Yorkshire Hospitals serve a population of ∼560 000. Patients admitted with ACS to cardiology or general medical wards were identified prospectively by trained nurses during 2005. Patients with a death or discharge code of MI were also identified by the hospital information department and, independently, from Myocardial Infarction National Audit Project (MINAP) records. The hospital laboratory identified all patients with an elevated serum troponin-T (TnT) by contemporary criteria (>0.03 µg/L in 2005). RESULTS The prospective survey identified 1731 admissions (1439 patients) with ACS, including 764 admissions (704 patients) with MIs. The hospital information department reported only 552 admissions (544 patients) with MI and only 206 admissions (203 patients) were reported to the MINAP. Using all 3 strategies, 934 admissions (873 patients) for MI were identified, for which TnT was >1 µg/L in 443, 0.04-1.0 µg/L in 435, ≤0.03 µg/L in 19 and not recorded in 37. A further 823 patients had TnT >0.03 µg/L, but did not have ACS ascertained by any survey method. Of the 873 patients with MI, 146 (16.7%) died during admission and 218 (25.0%) by 1 year, but ranging from 9% for patients enrolled in the MINAP to 27% for those identified by the hospital information department. CONCLUSIONS MINAP and hospital statistics grossly underestimated the incidence of MI managed by our hospital. The 1-year mortality was highly dependent on the method of ascertainment.
Collapse
Affiliation(s)
- Azam Torabi
- Department of Cardiology, Castle Hill Hospital, Hull York Medical School, University of Hull, Kingston upon Hull, UK; Department of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Kingston upon Hull, UK
| | | | - Nasser Sherwi
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Paul Atkin
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Hossein Panahi
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Eric Kilpatrick
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Simon Thackray
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Angela Hoye
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Farqad Alamgir
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Kevin Goode
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Alan Rigby
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| | - Andrew L Clark
- Department of Cardiology , Castle Hill Hospital, Hull York Medical School, University of Hull , Kingston upon Hull , UK
| |
Collapse
|
45
|
Batlle M, Campos B, Farrero M, Cardona M, González B, Castel MA, Ortiz J, Roig E, Pulgarín MJ, Ramírez J, Bedini JL, Sabaté M, García de Frutos P, Pérez-Villa F. Use of serum levels of high sensitivity troponin T, galectin-3 and C-terminal propeptide of type I procollagen at long term follow-up in heart failure patients with reduced ejection fraction: Comparison with soluble AXL and BNP. Int J Cardiol 2016; 225:113-119. [PMID: 27718443 DOI: 10.1016/j.ijcard.2016.09.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP. METHODS HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables. A Cox regression model was used to determine predictors for clinical events, i.e. all-cause mortality and heart transplantation. RESULTS Hs-TnT circulating values were correlated to clinical characteristics indicative of more advanced HF. When analyzing the event-free survival at a mean follow-up of 3.6years, patients in the higher quartile of either BNP, hs-TnT, CICP and sAXL had increased risk of suffering a clinical event, but not Gal-3. Combination of high sAXL and BNP values had greater predictive value (HR 6.8) than high BNP alone (HR 4.9). In a multivariate Cox regression analysis, BNP, sAXL and NYHA class were independent risk factors for clinical events. CONCLUSIONS In this HF cohort, hs-TnT is a good HF marker and has a very significant prognostic value. The prognostic value of CICP and sAXL was of less significance. However, hs-TnT did not add predictive value to BNP, while sAXL did. This suggests that elevated troponin has a common origin with BNP, while sAXL could represent an independent pathological mechanism.
Collapse
Affiliation(s)
- M Batlle
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Cardiovascular Clinic Institute, Hospital Clínic de Barcelona, Spain.
| | - B Campos
- Department of Public Health, Universitat de Barcelona, Spain
| | - M Farrero
- Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
| | - M Cardona
- Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
| | - B González
- Core Laboratory, Hospital Clínic de Barcelona, Spain
| | - M A Castel
- Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
| | - J Ortiz
- Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
| | - E Roig
- Heart Failure Unit at the Cardiology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica (IIB Sant Pau), Universitat Autònoma de Barcelona, Spain
| | - M J Pulgarín
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Cardiovascular Clinic Institute, Hospital Clínic de Barcelona, Spain
| | - J Ramírez
- Pathological Anatomy Department, Hospital Clínic de Barcelona, Spain
| | - J L Bedini
- Core Laboratory, Hospital Clínic de Barcelona, Spain
| | - M Sabaté
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Cardiovascular Clinic Institute, Hospital Clínic de Barcelona, Spain
| | - P García de Frutos
- Department of Cell Death and Proliferation at Institut d'Investigacions Biomèdiques de Barcelona (IIBB-CSIC) and IDIBAPS, Spain
| | - F Pérez-Villa
- Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
| |
Collapse
|
46
|
Prognostic Value of High-Sensitivity Troponin-T to Identify Patients at Risk of Left Ventricular Graft Dysfunction After Heart Transplantation. Transplant Proc 2016; 48:3021-3023. [DOI: 10.1016/j.transproceed.2016.07.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/27/2016] [Indexed: 11/21/2022]
|
47
|
Mommersteeg PMC, Schoemaker RG, Naudé PJW, Eisel ULM, Garrelds IM, Schalkwijk CG, Westerhuis BWJJM, Kop WJ, Denollet J. Depression and markers of inflammation as predictors of all-cause mortality in heart failure. Brain Behav Immun 2016; 57:144-150. [PMID: 27013355 DOI: 10.1016/j.bbi.2016.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/04/2016] [Accepted: 03/17/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND In patients with heart failure (HF) depressive symptoms have been associated with mortality, as well as biological risk factors, including inflammation, nitric oxide (NO) regulation, and oxidative stress. We investigated the joint predictive value of depressive symptoms, inflammation and NO regulation on all-cause mortality in patients with HF, adjusted for covariates. METHODS Serum levels of inflammation (TNFα, sTNFr1, sTNFr2, IL-6, hsCRP, NGAL), NO regulation (l-arginine, ADMA, and SDMA), and oxidative stress (isoprostane 8-Epi Prostaglandin F2 Alpha) were measured in 104 patients with HF (mean age 65.7±SD 8.4years, 28% women). Depressive symptoms (Beck Depression Inventory, BDI) were measured as continuous total, cognitive, and somatic symptoms, as well as categorized presence of mild/moderate depression (cut-off BDI ⩾10). In Cox proportional hazard models we adjusted for age, sex, poor exercise tolerance and comorbidity. RESULTS After on average 6.1years follow-up (SD=2.9, range 0.4-9.2), 49 patients died. Total and somatic depressive symptoms, mild/moderate depression, higher NGAL, sTNFr2, IL-6, hsCRP and SDMA serum levels were significantly associated with a higher all-cause mortality rate, adjusted for covariates. The findings were most consistent for CRP level and somatic depressive symptoms. When combined, both depressive symptoms and markers of inflammation and NO regulation remained significantly associated with all-cause mortality. These associations were not confounded by age, sex, poor exercise tolerance and comorbidity. CONCLUSION Depressive symptoms and markers of inflammation and NO regulation are codominant risk factors for all-cause mortality in heart failure.
Collapse
Affiliation(s)
- Paula M C Mommersteeg
- CoRPS, Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Regien G Schoemaker
- Department of Molecular Neurobiology, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands; Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
| | - Petrus J W Naudé
- Department of Molecular Neurobiology, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands; Department of Neurology and Alzheimer Research Centre, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands.
| | - Ulrich L M Eisel
- Department of Molecular Neurobiology, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands; Department of Neurology and Alzheimer Research Centre, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands.
| | - Ingrid M Garrelds
- Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus Medical Center, The Netherlands.
| | - Casper G Schalkwijk
- Department of Internal Medicine, Laboratory for Metabolism and Vascular Medicine, CARIM, Maastricht University Medical Centre, Peter Debeyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Bert W J J M Westerhuis
- Clinical Chemistry and Hematology Laboratory, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
| | - Willem J Kop
- CoRPS, Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Johan Denollet
- CoRPS, Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| |
Collapse
|
48
|
Resl M, Clodi M, Vila G, Luger A, Neuhold S, Wurm R, Adlbrecht C, Strunk G, Fritzer-Szekeres M, Prager R, Pacher R, Hülsmann M. Targeted multiple biomarker approach in predicting cardiovascular events in patients with diabetes. Heart 2016; 102:1963-1968. [DOI: 10.1136/heartjnl-2015-308949] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 06/09/2016] [Accepted: 06/20/2016] [Indexed: 11/04/2022] Open
|
49
|
George M, Jena A, Srivatsan V, Muthukumar R, Dhandapani VE. GDF 15--A Novel Biomarker in the Offing for Heart Failure. Curr Cardiol Rev 2016; 12:37-46. [PMID: 26750722 PMCID: PMC4807717 DOI: 10.2174/1573403x12666160111125304] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/28/2015] [Indexed: 12/26/2022] Open
Abstract
Background: Several diagnostic and prognostic biomarkers are being explored in heart failure.
GDF-15 belongs to the transforming growth factor β (TGF-β) cytokine family that is highly up
regulated in inflammatory conditions. We undertook this systematic review to summarize the current
evidence on the utility of GDF-15 as a biomarker in heart failure. Design and Methods: Multiple electronic databases for studies that reported the association between
GDF- 15 and heart failure were searched using different electronic databases such as MEDLINE, Science
Direct, Springer Link, Scopus, Cochrane Reviews, and Google Scholar using pre-defined inclusion-
exclusion criteria. Results: Twenty one original studies were identified that included data from 20,920 study participants. GDF 15 was found
to be a strong prognosticator of all-cause mortality in heart failure patients. Several studies found the benefit of using
GDF-15 as a component of a multi-biomarker strategy in prognosticating patients with heart failure. Conclusion: More studies are warranted to elucidate the molecular pathways involving GDF-15 and to see how knowledge
about GDF-15 can be used to make therapeutic decisions in the clinic.
Collapse
Affiliation(s)
- Melvin George
- SRM Medical College Hospital & Research Centre-Cardiology, Chennai, Tamil Nadu, India.
| | | | | | | | | |
Collapse
|
50
|
van der Hoeven NW, Hollander MR, Yıldırım C, Jansen MF, Teunissen PF, Horrevoets AJ, van der Pouw Kraan TCTM, van Royen N. The emerging role of galectins in cardiovascular disease. Vascul Pharmacol 2016; 81:31-41. [PMID: 26945624 DOI: 10.1016/j.vph.2016.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/08/2015] [Accepted: 02/22/2016] [Indexed: 01/06/2023]
Abstract
Galectins are an ancient family of β-galactoside-specific lectins and consist of 15 different types, each with a specific function. They play a role in the immune system, inflammation, wound healing and carcinogenesis. In particular the role of galectin in cancer is widely studied. Lately, the role of galectins in the development of cardiovascular disease has gained attention. Worldwide cardiovascular disease is still the leading cause of death. In ischemic heart disease, atherosclerosis limits adequate blood flow. Angiogenesis and arteriogenesis are highly important mechanisms relieving ischemia by restoring perfusion to the post-stenotic myocardial area. Galectins act ambiguous, both relieving ischemia and accelerating atherosclerosis. Atherosclerosis can ultimately lead to myocardial infarction or ischemic stroke, which are both associated with galectins. There is also a role for galectins in the development of myocarditis by their influence on inflammatory processes. Moreover, galectin acts as a biomarker for the severity of myocardial ischemia and heart failure. This review summarizes the association between galectins and the development of multiple cardiovascular diseases such as myocarditis, ischemic stroke, myocardial infarction, heart failure and atrial fibrillation. Furthermore it focuses on the association between galectin and more general mechanisms such as angiogenesis, arteriogenesis and atherosclerosis.
Collapse
Affiliation(s)
| | - Maurits R Hollander
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Cansu Yıldırım
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands
| | - Matthijs F Jansen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul F Teunissen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Anton J Horrevoets
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Niels van Royen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|