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Keranov S, Widmann L, Jafari L, Liebetrau C, Keller T, Troidl C, Kriechbaum S, Voss S, Bauer P, Richter MJ, Tello K, Gall H, Ghofrani HA, Wiedenroth CB, Guth S, Seeger W, Hamm CW, Nef H, Dörr O. GDF-15 and soluble ST2 as biomarkers of right ventricular dysfunction in pulmonary hypertension. Biomark Med 2022; 16:1193-1207. [PMID: 36790217 DOI: 10.2217/bmm-2022-0395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Background: This study analyzed the utility of soluble ST2 (sST2) and GDF-15 as biomarkers of right ventricular (RV) function in patients with pulmonary hypertension (PH). Methods: GDF-15 and sST2 serum concentrations were measured in patients with PH (n = 628), dilated cardiomyopathy (n = 31) and left ventricular hypertrophy (n = 47), and in healthy controls (n = 61). Results: Median sST2 and GDF-15 levels in patients with left ventricular hypertrophy were higher than in patients with PH and dilated cardiomyopathy. In tertile analysis GDF-15 >1363 pg/ml and sST2 >38 ng/ml were associated with higher N-terminal pro-brain natriuretic peptide, RV systolic dysfunction, RV-pulmonary arterial uncoupling and hemodynamic impairment. Conclusion: GDF-15 and sST2 are potential biomarkers of RV dysfunction in patients with PH.
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Affiliation(s)
- Stanislav Keranov
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
| | - Laila Widmann
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
| | - Leili Jafari
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | | | - Till Keller
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Christian Troidl
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Steffen Kriechbaum
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Sandra Voss
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Pascal Bauer
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
| | - Manuel J Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen & Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, 35392, Germany
| | - Khodr Tello
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen & Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, 35392, Germany
| | - Henning Gall
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen & Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, 35392, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen & Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, 35392, Germany
| | - Christoph B Wiedenroth
- Department of Thoracic Surgery, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Stefan Guth
- Department of Thoracic Surgery, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Werner Seeger
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen & Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, 35392, Germany
| | - Christian W Hamm
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
- Department of Cardiology, Kerckhoff Heart & Lung Center, Bad Nauheim, 61231, Germany
| | - Holger Nef
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
| | - Oliver Dörr
- Department of Cardiology & Angiology, University of Giessen, Giessen, 35392, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, 61231, Germany
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Mohl W, Molnár L, Merkely B. Cardiac Vein Anatomy and Transcoronary Sinus Catheter Interventions in Myocardial Ischemia. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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3
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Novel Biomarkers in Heart Failure: New Insight in Pathophysiology and Clinical Perspective. J Clin Med 2021; 10:jcm10132771. [PMID: 34202603 PMCID: PMC8268524 DOI: 10.3390/jcm10132771] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/18/2022] Open
Abstract
Heart failure (HF) is a complex clinical syndrome with a huge social burden in terms of cost, morbidity, and mortality. Brain natriuretic peptide (BNP) appears to be the gold standard in supporting the daily clinical management of patients with HF. Novel biomarkers may supplement BNP to improve the understanding of this complex disease process and, possibly, to personalize care for the different phenotypes, in order to ameliorate prognosis. In this review, we will examine some of the most promising novel biomarkers in HF. Inflammation plays a pivotal role in the genesis and progression of HF and, therefore, several candidate molecules have been investigated in recent years for diagnosis, prognosis, and therapy monitoring. Noncoding RNAs are attractive as biomarkers and their potential clinical applications may be feasible in the era of personalized medicine. Given the complex pathophysiology of HF, it is reasonable to expect that the future of biomarkers lies in the application of precision medicine, through wider testing panels and “omics” technologies, to further improve HF care delivery.
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Combination Biomarkers for Risk Stratification in Patients With Chronic Heart Failure Biomarkers Prognostication in HF. J Card Fail 2021; 27:1321-1327. [PMID: 34153460 DOI: 10.1016/j.cardfail.2021.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Current guidelines recommend measuring natriuretic peptide biomarkers to establish prognosis in patients with chronic heart failure with reduced ejection fraction (HFrEF). We assessed whether a combination biomarkers approach improve prognostication in patients with stable HFrEF. METHODS AND RESULTS An observational cohort study recruited 202 patients with stable HFrEF at a single center, tertiary care hospital undergoing elective cardiac resynchronization therapy device placement from 2013 to 2015. Twenty-four biomarkers were analyzed individually and in combination using Cox proportion hazard regression model for major adverse cardiac events (ie, death, cardiac transplant, left ventricular assist device placement), and major adverse cardiac events plus HF hospitalizations. The single best biomarker for predicting major adverse cardiac events is peripheral mid-regional pro-adrenomedullin (C statistic = 0.771 ± 0.045) compared to current guideline recommended N-terminal pro b-type natriuretic peptide (C=0.668 ± 0.046). The best combined biomarkers for predicting major adverse cardiac events are blood urea nitrogen, coronary sinus C-reactive protein, peripheral mid-regional pro-atrial natriuretic peptide and peripheral soluble IL-1 receptor-like 1 (C = 0.767 ± 0.036). CONCLUSIONS In this observational cohort, the combined biomarkers (blood urea nitrogen, C-reactive protein, mid-regional pro-atrial natriuretic peptide and soluble IL-1 receptor-like 1) or the single biomarker (mid-regional pro-adrenomedullin) was superior to N-terminal pro B-type natriuretic peptide, the current guideline recommended biomarker in predicting cardiovascular outcomes in patients with HFrEF. Larger studies are needed to validate these findings and examine whether single or combined biomarkers improve HFrEF prognostication.
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5
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Dimitropoulos S, Mystakidi VC, Oikonomou E, Siasos G, Tsigkou V, Athanasiou D, Gouliopoulos N, Bletsa E, Kalampogias A, Charalambous G, Tsioufis C, Vavuranakis M, Tousoulis D. Association of Soluble Suppression of Tumorigenesis-2 (ST2) with Endothelial Function in Patients with Ischemic Heart Failure. Int J Mol Sci 2020; 21:ijms21249385. [PMID: 33317161 PMCID: PMC7764062 DOI: 10.3390/ijms21249385] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 02/07/2023] Open
Abstract
Soluble suppression of tumorigenesis-2 (sST2) has been introduced as a marker associated with heart failure (HF) pathophysiology and status. Endothelial dysfunction is a component underlying HF pathophysiology. Therefore, we examined the association of arterial wall properties with sST2 levels in patients with HF of ischemic etiology. We enrolled 143 patients with stable HF of ischemic etiology and reduced left ventricular ejection fraction (LVEF) and 77 control subjects. Flow-mediated dilation (FMD) was used to evaluate endothelial function and pulse wave velocity (PWV) to assess arterial stiffness. Although there was no significant difference in baseline demographic characteristics, levels of sST2 were increased in HF compared to the control (15.8 (11.0, 21.8) ng/mL vs. 12.5 (10.4, 16.3) ng/mL; p < 0.001). In the HF group, there was a positive correlation of sST2 levels with age (rho = 0.22; p = 0.007) while there was no association of LVEF with sST2 (rho = −0.119; p = 0.17) nor with PWV (rho = 0.1; p = 0.23). Interestingly, sST2 was increased in NYHA III [20.0 (12.3, 25.7) ng/mL] compared to patients with NYHA II (15.0 (10.4, 18.2) ng/mL; p = 0.003) and inversely associated with FMD (rho = −0.44; p < 0.001) even after adjustment for possible confounders. In patients with chronic HF of ischemic etiology, sST2 levels are increased and are associated with functional capacity. There is an inverse association between FMD and sST2 levels, highlighting the interplay between the dysfunctional endothelium and HF pathophysiologic mechanisms.
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Affiliation(s)
- Stathis Dimitropoulos
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Vasiliki Chara Mystakidi
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Evangelos Oikonomou
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
- Third Department of Cardiology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
- Correspondence: , Tel.: +30-210-7763488
| | - Gerasimos Siasos
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
- Third Department of Cardiology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Vasiliki Tsigkou
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Dimitris Athanasiou
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Nikolaos Gouliopoulos
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Evanthia Bletsa
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Aimilios Kalampogias
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Georgios Charalambous
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Costas Tsioufis
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
| | - Manolis Vavuranakis
- Third Department of Cardiology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Dimitris Tousoulis
- First Department of Cardiology, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.D.); (V.C.M.); (G.S.); (V.T.); (D.A.); (N.G.); (E.B.); (A.K.); (G.C.); (C.T.); (D.T.)
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6
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Heggermont W, Auricchio A, Vanderheyden M. Biomarkers to predict the response to cardiac resynchronization therapy. Europace 2020; 21:1609-1620. [PMID: 31681965 DOI: 10.1093/europace/euz168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/23/2019] [Indexed: 12/17/2022] Open
Abstract
Cardiac resynchronization therapy (CRT) is an established non-pharmacological treatment for selected heart failure patients with wide QRS duration. However, there is a persistent number of non-responders throughout. The prediction of the CRT response is paramount to adequately select the correct patients for CRT. One of the expanding fields of research is the development of biomarkers that predict the response to CRT. A review of the available literature on biomarkers in CRT patients has been performed to formulate a critical appraisal of the available data. The main conclusion of our review is that biomarker research in this patient population is very fragmented and broad. This results in the use of non-uniform endpoints to define the CRT response, which precludes an in-depth comparison of the available data. To improve research development in this field, a uniform definition of the CRT response and relevant endpoints is necessary to better predict the CRT response.
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Affiliation(s)
- Ward Heggermont
- Cardiovascular Research Centre, OLV Hospital Aalst, Moorselbaan 164, B, Aalst, Belgium.,Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, Maastricht, The Netherlands
| | - Angelo Auricchio
- Cardiocentro Ticino, Department of Electrophysiology, Via Tesserete 48, CH, Lugano, Switzerland.,Centre for Computational Medicine in Cardiology, Via Buffi 13, CH-6900, Lugano, Switzerland
| | - Marc Vanderheyden
- Cardiovascular Research Centre, OLV Hospital Aalst, Moorselbaan 164, B, Aalst, Belgium
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7
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Silverman DN, Rambod M, Lustgarten DL, Lobel R, LeWinter MM, Meyer M. Heart Rate-Induced Myocardial Ca 2+ Retention and Left Ventricular Volume Loss in Patients With Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2020; 9:e017215. [PMID: 32856526 PMCID: PMC7660766 DOI: 10.1161/jaha.120.017215] [Citation(s) in RCA: 24] [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] [Indexed: 12/21/2022]
Abstract
Background Increases in heart rate are thought to result in incomplete left ventricular (LV) relaxation and elevated filling pressures in patients with heart failure with preserved ejection fraction (HFpEF). Experimental studies in isolated human myocardium have suggested that incomplete relaxation is a result of cellular Ca2+ overload caused by increased myocardial Na+ levels. We tested these heart rate paradigms in patients with HFpEF and referent controls without hypertension. Methods and Results In 22 fully sedated and instrumented patients (12 controls and 10 patients with HFpEF) in sinus rhythm with a preserved ejection fraction (≥50%) we assessed left‐sided filling pressures and volumes in sinus rhythm and with atrial pacing (95 beats per minute and 125 beats per minute) before atrial fibrillation ablation. Coronary sinus blood samples and flow measurements were also obtained. Seven women and 15 men were studied (aged 59±10 years, ejection fraction 61%±4%). Patients with HFpEF had a history of hypertension, dyspnea on exertion, concentric LV remodeling and a dilated left atrium, whereas controls did not. Pacing at 125 beats per minute lowered the mean LV end‐diastolic pressure in both groups (controls −4.3±4.1 mm Hg versus patients with HFpEF −8.5±6.0 mm Hg, P=0.08). Pacing also reduced LV end‐diastolic volumes. The volume loss was about twice as much in the HFpEF group (controls −15%±14% versus patients with HFpEF −32%±11%, P=0.009). Coronary venous [Ca2+] increased after pacing at 125 beats per minute in patients with HFpEF but not in controls. [Na+] did not change. Conclusions Higher resting heart rates are associated with lower filling pressures in patients with and without HFpEF. Incomplete relaxation and LV filling at high heart rates lead to a reduction in LV volumes that is more pronounced in patients with HFpEF and may be associated with myocardial Ca2+ retention.
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Affiliation(s)
- Daniel N Silverman
- Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC
| | - Mehdi Rambod
- Cardiology Division Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT
| | - Daniel L Lustgarten
- Cardiology Division Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT
| | - Robert Lobel
- Cardiology Division Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT
| | - Martin M LeWinter
- Cardiology Division Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT
| | - Markus Meyer
- Cardiology Division Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT.,Cardiology Division Department of Medicine University of Minnesota College of Medicine Minneapolis MN
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8
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Aimo A, Januzzi JL, Bayes-Genis A, Vergaro G, Sciarrone P, Passino C, Emdin M. Clinical and Prognostic Significance of sST2 in Heart Failure: JACC Review Topic of the Week. J Am Coll Cardiol 2020; 74:2193-2203. [PMID: 31648713 DOI: 10.1016/j.jacc.2019.08.1039] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/07/2019] [Accepted: 08/31/2019] [Indexed: 02/07/2023]
Abstract
Soluble suppression of tumorigenesis-2 (sST2) is released in response to vascular congestion and inflammatory and pro-fibrotic stimuli, and is a strong, independent predictor of mortality and heart failure (HF) hospitalization in patients with acute or chronic HF. sST2 meets 2 fundamental criteria for clinically useful biomarkers: accurate, repeated measurements are available at a reasonable cost, and the biomarker provides information not already available from a careful clinical assessment. In particular, the prognostic value of sST2 is additive to natriuretic peptides and (in the case of chronic HF) to high-sensitivity troponin T. Nevertheless, the need for a multibiomarker approach to risk stratification and the role of sST2 as a guide to therapy decision-making remain to be established. Four years after a consensus document on sST2, and following major advances in the comprehension of the clinical value of this biomarker, the authors felt it worthwhile to reappraise current knowledge on sST2 in HF.
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Affiliation(s)
- Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - James L Januzzi
- Massachusetts General Hospital and Baim Institute for Clinical Research, Boston, Massachusetts
| | - Antoni Bayes-Genis
- Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), CIBERCV, Barcelona, Spain
| | - Giuseppe Vergaro
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Paolo Sciarrone
- Cardiology Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Claudio Passino
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
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9
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Asgardoon MH, Vasheghani-Farahani A, Sherafati A. Usefulness of Biomarkers for Predicting Response to Cardiac Resynchronization Therapy. Curr Cardiol Rev 2019; 16:132-140. [PMID: 31822259 PMCID: PMC7460709 DOI: 10.2174/1573403x15666191206163846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/08/2019] [Accepted: 11/16/2019] [Indexed: 01/08/2023] Open
Abstract
Cardiac Resynchronization Therapy (CRT) is an effective treatment strategy for heart failure. It significantly improves clinical symptoms and decreases mortality and long-term morbidity. However, some patients do not respond properly to this treatment. In this review, the role of different biomarkers in predicting response to CRT is discussed. Some biomarkers, including natriuretic peptides and inflammatory markers have promising results but further trials are needed for more evaluation.
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Affiliation(s)
- Mohammad H Asgardoon
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Student Society for Immunodeficiencies, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alborz Sherafati
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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10
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Beaudoin J, Szymonifka J, Lavender Z, Deaño RC, Zhou Q, Januzzi JL, Singh JP, Truong QA. Relationship of soluble ST2 to pulmonary hypertension severity in patients undergoing cardiac resynchronization therapy. J Thorac Dis 2019; 11:5362-5371. [PMID: 32030254 DOI: 10.21037/jtd.2019.11.66] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background Pulmonary hypertension (PH) is an adverse prognostic marker in patients undergoing cardiac resynchronization therapy (CRT). We sought to determine the relation of biomarkers of fibrosis [soluble ST2 (sST2), galectin-3], wall stretch [amino terminal pro-brain natriuretic peptide (NT-proBNP)], and necrosis [high-sensitivity troponin-I (hsTnI)] to PH severity in CRT patients. Methods Biomarkers and right ventricular systolic pressure (RVSP) were measured at CRT implant and 6-month later (n=111). PH was categorized into 3 groups based on RVSP: no (<35 mmHg), mild-moderate (35-60 mmHg), and severe (>60 mmHg). Patients were categorized as progressors (worsened PH), persistent PH (no change) and regressors (improved PH). Endpoints were 6-month CRT response and 2-year major adverse cardiac event (MACE). Results RVSP was associated with CRT nonresponse (P=0.02) and MACE (P=0.03). Severe PH patients had 5-fold increase risk for CRT nonresponse (OR 5.0, P=0.04) and MACE (HR 5.7, P=0.04) over non-PH patients. Progressors and persistent PH patients had >2-fold odds for CRT non-response (OR 2.8, P=0.45) and >11-fold increase in MACE compared to no PH patients or regressors (HR 11.6, P=0.02). Only NT-proBNP and sST2 were discernable between PH groups, with graded increase based on PH severity (both P≤0.02), and lower values in regressors versus non-regressors (both P≤0.01). Levels of sST2 decreased at 6 months in regressors (15 ng/mL, P=0.03) and increased slightly (3-8 ng/mL) in non-regressors, without difference for NT-proBNP (P=0.08). Conclusions sST2 levels are related with PH severity in CRT patients. Serial sST2 changes after CRT implant suggests potential role to monitor PH after CRT.
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Affiliation(s)
- Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, QC, Canada
| | | | | | - Roderick C Deaño
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Qing Zhou
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Quynh A Truong
- Department of Biostatistics, New York University, New York, NY, USA.,Division of Cardiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
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11
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Arrigo M, Vodovar N, Nougué H, Sadoune M, Pemberton CJ, Ballan P, Ludes PO, Gendron N, Carpentier A, Cholley B, Bizouarn P, Cohen-Solal A, Singh JP, Szymonifka J, Latremouille C, Samuel JL, Launay JM, Pottecher J, Richards AM, Truong QA, Smadja DM, Mebazaa A. The heart regulates the endocrine response to heart failure: cardiac contribution to circulating neprilysin. Eur Heart J 2019; 39:1794-1798. [PMID: 29244074 DOI: 10.1093/eurheartj/ehx679] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 11/01/2017] [Indexed: 12/11/2022] Open
Abstract
Aims Heart failure (HF) is accompanied by major neuroendocrine changes including the activation of the natriuretic peptide (NP) pathway. Using the unique model of patients undergoing implantation of the CARMAT total artificial heart and investigating regional differences in soluble neprilysin (sNEP) in patients with reduced or preserved systolic function, we studied the regulation of the NP pathway in HF. Methods and results Venous blood samples from two patients undergoing replacement of the failing ventricles with a total artificial heart were collected before implantation and weekly thereafter until post-operative week 6. The ventricular removal was associated with an immediate drop in circulating NPs, a nearly total disappearance of circulating glycosylated proBNP and furin activity and a marked decrease in sNEP. From post-operative week 1 onwards, NP concentrations remained overall unchanged. In contrast, partial recoveries in glycosylated proBNP, furin activity, and sNEP were observed. Furthermore, while in patients with preserved systolic function (n = 6), sNEP concentrations in the coronary sinus and systemic vessels were similar (all P > 0.05), in patients with reduced left-ventricular systolic function, sNEP concentration, and activity were ∼three-fold higher in coronary sinus compared to systemic vessels (n = 21, all P < 0.0001), while the trans-pulmonary gradient was neutral (n = 5, P = 1.0). Conclusion The heart plays a pivotal role as a regulator of the endocrine response in systolic dysfunction, not only by directly releasing NPs but also by contributing to circulating sNEP, which in turn determines the bioavailability of other numerous vasoactive peptides.
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Affiliation(s)
- Mattia Arrigo
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Hélène Nougué
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France.,Department of Anaesthesiology and Intensive Care, Lariboisière Hospital, Paris, France
| | - Malha Sadoune
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France
| | | | - Pamela Ballan
- Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
| | - Pierre-Olivier Ludes
- Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
| | - Nicolas Gendron
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,Inserm UMR-S 1140, Faculté de Pharmacie, Paris, France.,Department of Haematology, Georges Pompidou European Hospital, Paris, France
| | - Alain Carpentier
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,Department of Cardiovascular Surgery, Georges Pompidou European Hospital, Paris, France
| | - Bernard Cholley
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,Department of Anaesthesiology and Intensive Care, Georges Pompidou European Hospital, Paris, France
| | - Philippe Bizouarn
- Department of Anaesthesiology and Intensive Care, CHU Nantes, France
| | - Alain Cohen-Solal
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France.,Université Paris Diderot-Sorbonne Paris Cité, Paris, France.,Department of Cardiology, Lariboisière Hospital, Paris, France
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jackie Szymonifka
- Department of Radiology and Division of Cardiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Christian Latremouille
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,Department of Cardiovascular Surgery, Georges Pompidou European Hospital, Paris, France
| | | | - Jean-Marie Launay
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France.,Centre for Biological Resources BB-0033-00064, Lariboisière Hospital, Paris, France
| | - Julien Pottecher
- Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - A Mark Richards
- University of Otago, Christchurch, New Zealand.,National University Health System, Singapore, Singapore
| | - Quynh A Truong
- Department of Radiology and Division of Cardiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - David M Smadja
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,Inserm UMR-S 1140, Faculté de Pharmacie, Paris, France.,Department of Haematology, Georges Pompidou European Hospital, Paris, France
| | - Alexandre Mebazaa
- Inserm UMR-S 942, Hôpital Lariboisière, Paris, France.,Department of Anaesthesiology and Intensive Care, Lariboisière Hospital, Paris, France.,Université Paris Diderot-Sorbonne Paris Cité, Paris, France
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12
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Skvortsov AA, Narusov OY, Muksinova MD. [Soluble ST2 - biomarker for prognosis and monitoring in decompensated heart failure]. ACTA ACUST UNITED AC 2019; 59:18-27. [PMID: 31884937 DOI: 10.18087/cardio.n765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022]
Abstract
The review aims to appraise the value of determining the concentrations of the new biomarker sST2 for assessing prognosis and monitoring treatment effectiveness of patients with decompensated heart failure during an episode of decompensation and during long-term follow-up after discharge from the hospital. The article analyses in detail the expedience of sST2 measurement in a patient with ADHF on admission and discharge from the hospital and the changes in the biomarker level during the period of active treatment for risk-stratification in patients, presents the optimal threshold values of sST2, which should be oriented when selecting patients with high and very high risk. The importance of subsequent monitoring of the marker concentration during long-term observation in emphasized to predict the risk of death, HF re-decompensation / HF rehospitalization. The potential benefits of choosing sST2 as the optimal marker for serial measurement during long-term follow-up, as well as evaluating the treatment effectiveness in patients with HF, compared to the "classical" variant - natriuretic peptides are shown.
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Affiliation(s)
- A A Skvortsov
- FSBO National Medical research center of cardiology of the Ministry of healthcare of the Russian Federation
| | - O Yu Narusov
- FSBO National Medical research center of cardiology of the Ministry of healthcare of the Russian Federation
| | - M D Muksinova
- FSBO National Medical research center of cardiology of the Ministry of healthcare of the Russian Federation
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13
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Damen SAJ, Vroemen WHM, Brouwer MA, Mezger STP, Suryapranata H, van Royen N, Bekers O, Meex SJR, Wodzig WKWH, Verheugt FWA, de Boer D, Cramer GE, Mingels AMA. Multi-Site Coronary Vein Sampling Study on Cardiac Troponin T Degradation in Non-ST-Segment-Elevation Myocardial Infarction: Toward a More Specific Cardiac Troponin T Assay. J Am Heart Assoc 2019; 8:e012602. [PMID: 31269858 PMCID: PMC6662151 DOI: 10.1161/jaha.119.012602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/17/2019] [Indexed: 01/24/2023]
Abstract
Background Cardiac troponin T ( cTnT ) is seen in many other conditions besides myocardial infarction, and recent studies demonstrated distinct forms of cTnT . At present, the in vivo formation of these different cTnT forms is incompletely understood. We therefore performed a study on the composition of cTnT during the course of myocardial infarction, including coronary venous system sampling, close to its site of release. Methods and Results Baseline samples were obtained from multiple coronary venous system locations, and a peripheral artery and vein in 71 non- ST -segment-elevation myocardial infarction patients. Additionally, peripheral blood was drawn at 6- and 12-hours postcatheterization. cTnT concentrations were measured using the high-sensitivity- cTnT immunoassay. The cTnT composition was determined via gel filtration chromatography and Western blotting in an early and late presenting patient. High-sensitivity - cTnT concentrations were 28% higher in the coronary venous system than peripherally (n=71, P<0.001). Coronary venous system samples demonstrated cT n T-I-C complex, free intact cTnT , and 29 kD a and 15 to 18 kD a cTnT fragments, all in higher concentrations than in simultaneously obtained peripheral samples. While cT n T-I-C complex proportionally decreased, and disappeared over time, 15 to 18 kD a cTnT fragments increased. Moreover, cT n T-I-C complex was more prominent in the early than in the late presenting patient. Conclusions This explorative study in non- ST -segment-elevation myocardial infarction shows that cTnT is released from cardiomyocytes as a combination of cT n T-I-C complex, free intact cTnT , and multiple cTnT fragments indicating intracellular cTnT degradation. Over time, the cT n T-I-C complex disappeared because of in vivo degradation. These insights might serve as a stepping stone toward a high-sensitivity- cTnT immunoassay more specific for myocardial infarction.
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Affiliation(s)
- Sander A. J. Damen
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Wim H. M. Vroemen
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - Marc A. Brouwer
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Stephanie T. P. Mezger
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - Harry Suryapranata
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Niels van Royen
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Otto Bekers
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - Steven J. R. Meex
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - Will K. W. H. Wodzig
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - Freek W. A. Verheugt
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Douwe de Boer
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - G. Etienne Cramer
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Alma M. A. Mingels
- Central Diagnostic LaboratoryMaastricht University Medical CenterMaastrichtThe Netherlands
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands
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14
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Du X, Zhao W, Nguyen M, Lu Q, Kiriazis H. β-Adrenoceptor activation affects galectin-3 as a biomarker and therapeutic target in heart disease. Br J Pharmacol 2019; 176:2449-2464. [PMID: 30756388 PMCID: PMC6592856 DOI: 10.1111/bph.14620] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/11/2018] [Accepted: 01/29/2019] [Indexed: 12/12/2022] Open
Abstract
Myocardial fibrosis is a key histopathological component that drives the progression of heart disease leading to heart failure and constitutes a therapeutic target. Recent preclinical and clinical studies have implicated galectin-3 (Gal-3) as a pro-fibrotic molecule and a biomarker of heart disease and fibrosis. However, our knowledge is poor on the mechanism(s) that determine the blood level or regulate cardiac expression of Gal-3. Recent studies have demonstrated that enhanced β-adrenoceptor activity is a determinant of both circulating concentration and cardiac expression of Gal-3. Pharmacological or transgenic activation of β-adrenoceptors leads to increased blood levels of Gal-3 and up-regulated cardiac Gal-3 expression, effect that can be reversed with the use of β-adrenoceptor antagonists. Conversely, Gal-3 gene deletion confers protection against isoprenaline-induced cardiotoxicity and fibrogenesis. At the transcription level, β-adrenoceptor stimulation activates cardiac mammalian sterile-20-like kinase 1, a pivotal kinase of the Hippo signalling pathway, which is associated with Gal-3 up-regulation. Recent studies have suggested a role for the β-adrenoceptor-Hippo signalling pathway in the regulation of cardiac Gal-3 expression thereby contributing to the onset and progression of heart disease. This implies a therapeutic potential of the suppression of Gal-3 expression. In this review, we discuss the effects of β-adrenoceptor activity on Gal-3 as a biomarker and causative mediator in the setting of heart disease and point out pivotal knowledge gaps. LINKED ARTICLES: This article is part of a themed section on Adrenoceptors-New Roles for Old Players. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.14/issuetoc.
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Affiliation(s)
- Xiao‐Jun Du
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
- Department of Physiology and Pathophysiology, School of Medical SciencesXi'an Jiaotong University Health Science CenterXi'anChina
| | - Wei‐Bo Zhao
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
| | - My‐Nhan Nguyen
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
| | - Qun Lu
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
- Department of Cardiovascular Medicine, First HospitalXi'an Jiaotong University Health Science CenterXi'anChina
| | - Helen Kiriazis
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
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15
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Katbeh A, Van Camp G, Barbato E, Galderisi M, Trimarco B, Bartunek J, Vanderheyden M, Penicka M. Cardiac Resynchronization Therapy Optimization: A Comprehensive Approach. Cardiology 2019; 142:116-128. [PMID: 31117077 DOI: 10.1159/000499192] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/26/2019] [Indexed: 11/19/2022]
Abstract
Since the first report on biventricular pacing in 1994, cardiac resynchronization therapy (CRT) has become standard for patients with advanced heart failure (HF) and ventricular conduction delay. CRT improves myocardial function by resynchronizing myocardial contraction, which results in reverse left ventricular remodeling and improves symptoms and clinical outcomes. Despite the accelerated development of CRT device technology and its increased application in treating HF patients, almost one-third of these patients do not respond to the therapy or gain any clinical benefit from device implantation. Over the last decade, multiple cardiac imaging modalities have provided a deeper understanding of myocardial pathophysiology, thereby improving HF treatment management. However, the optimal strategy for improving the CRT response remains debatable. This article provides an updated overview of the electropathophysiology of myocardial dysfunction in ventricular conduction delay and the diagnostic approaches involving the use of multiple modalities.
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Affiliation(s)
- Asim Katbeh
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.,Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Guy Van Camp
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
| | - Emanuele Barbato
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.,Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | - Martin Penicka
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium,
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16
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Suárez-Cuenca JA, Robledo-Nolasco R, Alcántara-Meléndez MA, Díaz Hernández LJ, Vera-Gómez E, Hernández-Patricio A, Sánchez-Díaz KS, Buendía-Gutiérrez JA, Contreras-Ramos A, Ruíz-Hernández AS, Pérez-Cabeza de Vaca R, Mondragón-Terán P. Coronary circulating mononuclear progenitor cells and soluble biomarkers in the cardiovascular prognosis after coronary angioplasty. J Cell Mol Med 2019; 23:4844-4849. [PMID: 31069956 PMCID: PMC6584722 DOI: 10.1111/jcmm.14336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/26/2019] [Accepted: 03/21/2019] [Indexed: 11/26/2022] Open
Abstract
Currently, there are no confident prognostic markers in patients with coronary artery disease (CAD) undergoing angioplasty. The present study aimed to explore whether basal coronary circulating Mononuclear Progenitor Cells (MPCs) and vascular injury biomarkers were related to development of major adverse cardiovascular events (MACEs) and may impact clinical prognosis. Methods The number of MPCs and soluble mediators such as IL‐1β, sICAM‐1, MMP‐9, malondialdehyde, superoxide dismutase and nitric oxide were determined in coronary and peripheral circulation. Prognostic ability for MACEs occurring at 6 months follow up was assessed by time‐to‐event and event free survival estimations. Results Lower coronary circulating MPCs subpopulations CD45+CD34+, CD45+CD34+CD133+CD184+, lower MMP‐9 and higher sICAM‐1 significantly associated with MACEs presentation and showed prognostic ability; while peripheral blood increase in malondialdehyde and decreased superoxide dismutase were observed in patients with MACEs. Conclusion Coronary concentration of biomarkers related with vascular repair, such as MPCs subpopulations and adhesion molecules, may predict MACEs and impact prognosis in patients with CAD undergoing angioplasty; whereas peripheral pro‐oxidative condition may be also associated.
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Affiliation(s)
- Juan Antonio Suárez-Cuenca
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico.,Internal Medicine Department, HGZ 58 "Gral. Manuel Ávila Camacho", IMSS, Mexico City, Mexico
| | - Rogelio Robledo-Nolasco
- Hemodynamics Unit, Cardiology Department, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | | | - Luis Javier Díaz Hernández
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Eduardo Vera-Gómez
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Alejandro Hernández-Patricio
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Karla Susana Sánchez-Díaz
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Juan Ariel Buendía-Gutiérrez
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Alejandra Contreras-Ramos
- Laboratorio de Biología del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Atzin Suá Ruíz-Hernández
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Rebeca Pérez-Cabeza de Vaca
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
| | - Paul Mondragón-Terán
- Laboratory of Experimental Metabolism and Clinical Research, División de Investigación, Centro Médico Nacional "20 de Noviembre" ISSSTE, Mexico City, Mexico
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17
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Sponder M, Lichtenauer M, Wernly B, Paar V, Hoppe U, Emich M, Fritzer-Szekeres M, Litschauer B, Strametz-Juranek J. Serum heart-type fatty acid-binding protein decreases and soluble isoform of suppression of tumorigenicity 2 increases significantly by long-term physical activity. J Investig Med 2018; 67:833-840. [PMID: 30593542 DOI: 10.1136/jim-2018-000913] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2018] [Indexed: 01/21/2023]
Abstract
The aim of this prospective study was to investigate the influence of long-term physical activity on biomarkers for myocyte ischemia (heart-type fatty acid-binding protein, H-FABP), matrix remodelling/vascular stress (soluble isoform of suppression of tumorigenicity 2, sST2) and inflammation (soluble urokinase-type plasminogen activator receptor, suPAR). In this prospective observational study 109 subjects were recruited, 98 completed the study. Subjects were asked to perform exercise within the calculated training pulse for 8 months. The performance gain was measured/quantified by bicycle stress tests at the beginning and end of the observation period. Twenty-seven subjects with a performance gain <2.9% were excluded. suPAR, H-FABP and sST2 were measured in serum at baseline and after 2, 4 and 8 months by ELISA. We found a significant decrease in H-FABP (1.86 (0.86) to 1.29 (0.98) ng/mL; p<0.01) and a significant increase in sST2 levels (6126 (2759) to 6919 (3720) pg/mL; p=0.045) during the observation period of 8 months while there was no remarkable change in suPAR levels. We interpret the activity-induced decrease in H-FABP as sign of lower subclinical myocardial ischemia and better perfusion, probably due to a more economic metabolization and electrolyte balance. The increase in sST2 might reflect physiological sports-induced vascular stress. As H-FABP and sST2 play an important role in the pathomechanism of ischemic cardiomyopathy (iCMP) further studies should investigate the influence of regular physical activity on these biomarkers in a population of patients with iCMP. TRIAL REGISTRATION NUMBER: NCT02097199.
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Affiliation(s)
- Michael Sponder
- Department of Cardiology, Medical University of Vienna, Vienna, Vienna, Austria
| | - Michael Lichtenauer
- Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Bernhard Wernly
- Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Vera Paar
- Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Uta Hoppe
- Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Michael Emich
- Austrian Federal Ministry of Defence and Sports, Austrian Armed Forces, Vienna, Austria
| | - Monika Fritzer-Szekeres
- Department of Medical-Chemical Laboratory Analysis, Medical University of Vienna, Vienna, Austria
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18
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Cardiorenal status using amino-terminal pro-brain natriuretic peptide and cystatin C on cardiac resynchronization therapy outcomes: From the BIOCRT Study. Heart Rhythm 2018; 16:928-935. [PMID: 30590191 DOI: 10.1016/j.hrthm.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cardiorenal syndrome comprises a heterogeneous group of disorders characterized by acute or chronic cardiac and renal dysfunction. OBJECTIVE The purpose of this study was to determine the effect of cardiorenal status using a dual-marker strategy with amino-terminal pro-brain natriuretic peptide (NT-proBNP) and cystatin C on cardiac resynchronization therapy (CRT) outcomes. METHODS In 92 patients (age 66 ± 13 years; 80% male; left ventricular ejection fraction 26% ± 7%), NT-proBNP and cystatin C levels were measured at CRT implantation and at 1 month. NT-proBNP >1000 pg/mL and cystatin C >1 mg/L were considered high. Baseline cardiorenal patients were defined as having high NT-proBNP and cystatin C. At 1 month, CRT patients were categorized as (1) irreversible cardiorenal if cystatin C was persistently high; (2) progressive cardiorenal with transition from low to high cystatin C; (3) reversible cardiorenal with transition from high to low cystatin C; and (4) "normal" with stable low cystatin C. Outcomes were 6-month clinical and echocardiographic CRT response and 2 -year major adverse cardiovascular event (MACE). RESULTS Compared to patients with low NT-proBNP and cystatin C, cardiorenal patients had >9-fold increase risk of CRT nonresponse (odds ratio uncompensated 9.0; compensated 36.4; both P ≤.004) and >6-fold risk of MACE (hazard ratio uncompensated 8.5; P = .005). Compared to "normal" and reversible patients (referent), irreversible patients had a 9-fold increase for CRT nonresponse (odds ratio 9.1; P <.001) and had >4-fold risk of MACE (adjusted hazard ratio 5.1; P <.001). Irreversible patients were most likely echocardiographic CRT nonresponders. CONCLUSION Cardiorenal status by NT-proBNP and cystatin C can identify high-risk CRT patients, and those with both elevated concentrations have worse prognosis.
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19
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Pascual-Figal DA, Pérez-Martínez MT, Asensio-Lopez MC, Sanchez-Más J, García-García ME, Martinez CM, Lencina M, Jara R, Januzzi JL, Lax A. Pulmonary Production of Soluble ST2 in Heart Failure. Circ Heart Fail 2018; 11:e005488. [DOI: 10.1161/circheartfailure.118.005488] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Domingo A. Pascual-Figal
- Department of Cardiology, Hospital Virgen de la Arrixaca, University of Murcia, Spain (D.A.P.-F., M.T.P.-M., M.C.A.-L., A.L.)
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain (D.A.P.-F.)
- CIBERCV, Madrid, Spain (D.A.P.-F.)
| | - Maria T. Pérez-Martínez
- Department of Cardiology, Hospital Virgen de la Arrixaca, University of Murcia, Spain (D.A.P.-F., M.T.P.-M., M.C.A.-L., A.L.)
- IMIB-Arrixaca, University of Murcia, Spain (M.T.P.-M., M.C.A.-L., C.M.M., A.L.)
| | - Maria C. Asensio-Lopez
- Department of Cardiology, Hospital Virgen de la Arrixaca, University of Murcia, Spain (D.A.P.-F., M.T.P.-M., M.C.A.-L., A.L.)
| | - Jesús Sanchez-Más
- Departamento de Ciencias Biomédicas, Universidad CEU Cardenal Herrera, Moncada, Valencia, Spain (J.S.-M.)
| | - Maria E. García-García
- Servicio de Medicina Intensiva, Hospital Virgen de la Arrixaca, Hospital Virgen de la Arrixaca, Murcia, Spain (M.E.G.-G., R.J.)
| | - Carlos M. Martinez
- IMIB-Arrixaca, University of Murcia, Spain (M.T.P.-M., M.C.A.-L., C.M.M., A.L.)
| | - Miriam Lencina
- Department of Pathological Anatomy, Hospital Virgen de la Arrixaca, Murcia, Spain (M.L.)
| | - Ruben Jara
- Servicio de Medicina Intensiva, Hospital Virgen de la Arrixaca, Hospital Virgen de la Arrixaca, Murcia, Spain (M.E.G.-G., R.J.)
| | - James L. Januzzi
- Division of Cardiology, Massachusetts General Hospital, Baim Institute for Clinical Research, Boston (J.L.J.)
| | - Antonio Lax
- IMIB-Arrixaca, University of Murcia, Spain (M.T.P.-M., M.C.A.-L., C.M.M., A.L.)
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20
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Enina TN, Kuznetsov VA, Soldatova AM, Petelina TI, Krinochkin DV, Rychkov AY, Nochrina OY. Gender in cardiac resynchronisation therapy. J Cardiovasc Thorac Res 2018; 10:197-202. [PMID: 30680077 PMCID: PMC6335983 DOI: 10.15171/jcvtr.2018.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 05/11/2018] [Indexed: 12/27/2022] Open
Abstract
Introduction:
Gender differences in cardiac resynchronisation therapy (CRT) response are
not clear enough. This study aimed to assess gender influence on systemic inflammation,
neurohormonal activation, fibrosis in patients with congestive heart failure (CHF) and CRT.
Methods: We compared group I (61 men) and group II (16 women) of patients undergoing
CRT. Plasma levels of Nt-proBNP, interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha
(TNF-α), C-reactive protein, galectin-3 (Gal-3), metalloproteinase-9 (MMP-9), tissue inhibitors
of metalloproteinase 1 and 4 (TIMP-1, TIMP-4), ratio MMP-9/TIMP-1, MMP-9/TIMP-4 were
measured. According to dynamics of left ventricular end-systolic volume patients were classified
into non-responders, responders, super-responders.
Results: Women more likely had left bundle branch block (81.3 vs 47.5%, P = 0.016), were more
super-responders (66.7 vs 30.5%). Both groups showed decrease of IL-6 (P < 0.05), TNF-α
(P < 0.001; P < 0.05), NT-proBNP (P = 0.001; P < 0.05), Gal-3 (P < 0.05). In women there was
decrease of IL-6 by 44.4 vs 23.5% in men (PP = 0.029), TNF-α by 41.4 vs 30.9%, NT-proBNP by 73.3
vs 46% (P = 0.002), Gal-3 by 82.3 vs 64.9% (P < 0.05). Group I also showed decrease of IL-10 by
34.2% (P < 0.05). Group dynamics of TIMP-1 was opposite: men showed tendency to reduction of
TIMP-1 (P = 0.054), women showed increase of TIMP-1 (P < 0.05). Besides, men showed decrease
of MMP-9 (P < 0.05) and ratio MMP-9/TIMP-4 (P < 0.05).
Conclusion: The best response to CRT is associated with female gender explained by greater
decrease of neurohormonal activation, systemic inflammation and fibrosis. The revealed opposite
dynamics of TIMP-1 in the groups can demonstrate the existence of gender features of matrix
metalloproteinase system activity and their tissue inhibitors.
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Affiliation(s)
- Tatiana N Enina
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Vadim A Kuznetsov
- Director of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Anna M Soldatova
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Tatiana I Petelina
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Dmitriy V Krinochkin
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Alexander Yu Rychkov
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Olga Yu Nochrina
- Scientific researcher in Instrumental Laboratory of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
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21
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NT-proBNP and CA 125 levels are associated with increased pro-inflammatory cytokines in coronary sinus serum of patients with chronic heart failure. Cytokine 2018; 111:13-19. [PMID: 30098475 DOI: 10.1016/j.cyto.2018.07.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Heart failure (HF) is considered to be a complex syndrome associated with neurohormonal and cytokine activation, that contribute to its progression. There are evidences which showed that, carbohydrate antigen 125 (CA 125), a tumor marker widely used for ovarian cancer therapy monitoring, was significantly elevated in HF patients. We hypothesized that inflammatory stimuli may be responsible for amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) and CA-125 production and release in chronic HF (CHF). We aimed to measure the levels of NT-proBNP, CA 125, pro-anti-inflammatory cytokines (IL-6, IL-1β, IL-8, TNF-α and IL-4), from peripheral venous (PV) and coronary sinus (CS) blood samples, in patients with CHF and to assess their correlation with echocardiographic indices. METHODS We enrolled 32 subjects (20M/12F) with CHF (III-IV NYHA functional class) who were to undergo cardiac resynchronization therapy (CRT) device implantation and 30 healthy controls (18M/12F). Two blood samples, from PV and CS, were collected at the time of CRT for each CHF patient. Serum levels of biomarkers were measured by ELISA. Cardiac function was assessed echocardiographically. RESULTS All investigated biomarkers were significantly higher in CHF patients than in non-CHF controls (P < 0.001). There were positive correlations between biomarkers concentrations in PV and CS (r between 0.54 and 0.98, all P < 0.003). NT-proBNP, IL-6 and IL-1β levels were 17%, 86% and 36% higher in CS than in PV, these increases being very well correlated each other, while CA 125 levels were 86% higher in PV than in CS. Moreover, CS NT-proBNP, CS IL-6 and CS IL-1β serum concentrations were inversely related to the echocardiographically determined left ventricular ejection fraction (LVEF) (r = -0.61, P < 0.001; r = -0.71, P < 0.001 and r = -0.48, P = 0.005, respectively). A positive relationship was found between CA 125 and IL-1β (r = 0.51, P = 0.003) in CS serum and between CA 125 and IL-6 (r = 0.43, P = 0.015), TNF-α (r = 0.46, P = 0.008) in PV serum. CA 125 concentrations were closely related to NT-proBNP both in CS (r = 0.46, P = 0.008) and PV (r = 0.52, P = 0.002). CONCLUSIONS CS sampling of NT-proBNP, CA 125 and pro-anti-inflammatory cytokines provides an additional insight into the possible mechanisms by which these biomarkers lead to left ventricular remodeling. Our results clearly suggest that serum NT-proBNP and CA 125 levels not only in PV, but also in CS of patients with CHF, may be dependent on inflammation as a consequence of cytokine network activation.
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22
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Arrigo M, Truong QA, Szymonifka J, Rivas-Lasarte M, Tolppanen H, Sadoune M, Gayat E, Cohen-Solal A, Ruschitzka F, Januzzi JL, Singh JP, Mebazaa A. Mid-regional pro-atrial natriuretic peptide to predict clinical course in heart failure patients undergoing cardiac resynchronization therapy. Europace 2018; 19:1848-1854. [PMID: 28096288 DOI: 10.1093/europace/euw305] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/30/2016] [Indexed: 11/14/2022] Open
Abstract
Aims Cardiac resynchronization therapy (CRT) induces reverse cardiac remodelling in heart failure (HF), but many patients receiving CRT remain non-responders. This study assessed the role of amino-terminal-pro-B-type natriuretic peptide (NT-proBNP), mid-regional-pro-atrial natriuretic peptide (MR-proANP), and mid-regional-pro-adrenomedullin (MR-proADM) at the time of device implantation to predict favourable clinical course (CRT response and/or risk of MACE) in HF patients receiving CRT. Methods and results A total of 137 HF patients were prospectively included. Blood was drawn from the coronary sinus (CS) at CRT implantation, and from a peripheral vein (PV) simultaneously and after 6 months. Clinical CRT response at 6 months and major adverse cardiovascular events (MACE) at 2 years were assessed. Baseline PV-levels of MR-proANP (202 vs. 318 pmol/L, P = 0.009) and MR-proADM (843 vs. 1112 pmol/L, P = 0.02) were lower in CRT responders compared with non-responders. At 6 months, CRT responders showed a decrease in MR-proANP levels, compared with an increase in non-responders (-32 vs. +7 pmol/L, P = 0.02). During the same period, NT-proBNP decreased by a similar way in responders and non-responders, while MR-proADM was unchanged in both groups. High baseline MR-proANP, either in PV (OR 0.41, 95% CI 0.24-0.71, P = 0.002) or CS (OR 0.32, 95% CI 0.15-0.70, P = 0.005) was associated with reduced likelihood of CRT response. Furthermore, PV and CS levels of NT-proBNP, MR-proANP, and MR-proADM were all associated with increased risk of 2-year MACE (all P < 0.01). Conclusion Mid-regional-pro-atrial natriuretic peptide may assist prediction of clinical course in HF patients undergoing CRT implantation. Low circulating MR-proANP at the time of device implantation is associated with CRT response and more favourable outcome.
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Affiliation(s)
- Mattia Arrigo
- INSERM UMR-S 942, Paris, France
- Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis and Lariboisière University Hospitals, 2, rue Ambroise Paré, Paris 75010, France
- Department of Cardiology, APHP, Lariboisière University Hospitals, Paris, France
- Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Quynh A Truong
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | - Jackie Szymonifka
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - Etienne Gayat
- INSERM UMR-S 942, Paris, France
- Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis and Lariboisière University Hospitals, 2, rue Ambroise Paré, Paris 75010, France
| | - Alain Cohen-Solal
- INSERM UMR-S 942, Paris, France
- Department of Cardiology, APHP, Lariboisière University Hospitals, Paris, France
| | - Frank Ruschitzka
- Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France
- Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis and Lariboisière University Hospitals, 2, rue Ambroise Paré, Paris 75010, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
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23
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Nguyen MN, Su Y, Vizi D, Fang L, Ellims AH, Zhao WB, Kiriazis H, Gao XM, Sadoshima J, Taylor AJ, McMullen JR, Dart AM, Kaye DM, Du XJ. Mechanisms responsible for increased circulating levels of galectin-3 in cardiomyopathy and heart failure. Sci Rep 2018; 8:8213. [PMID: 29844319 PMCID: PMC5973942 DOI: 10.1038/s41598-018-26115-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/16/2018] [Indexed: 12/12/2022] Open
Abstract
Galectin-3 is a biomarker of heart disease. However, it remains unknown whether increase in galectin-3 levels is dependent on aetiology or disease-associated conditions and whether diseased heart releases galectin-3 into the circulation. We explored these questions in mouse models of heart disease and in patients with cardiomyopathy. All mouse models (dilated cardiomyopathy, DCM; fibrotic cardiomyopathy, ischemia-reperfusion, I/R; treatment with β-adrenergic agonist isoproterenol) showed multi-fold increases in cardiac galectin-3 expression and preserved renal function. In mice with fibrotic cardiomyopathy, I/R or isoproterenol treatment, plasma galectin-3 levels and density of cardiac inflammatory cells were elevated. These models also exhibited parallel changes in cardiac and plasma galectin-3 levels and presence of trans-cardiac galectin-3 gradient, indicating cardiac release of galectin-3. DCM mice showed no change in circulating galectin-3 levels nor trans-cardiac galectin-3 gradient or myocardial inflammatory infiltration despite a 50-fold increase in cardiac galectin-3 content. In patients with hypertrophic cardiomyopathy or DCM, plasma galectin-3 increased only in those with renal dysfunction and a trans-cardiac galectin-3 gradient was not present. Collectively, this study documents the aetiology-dependency and diverse mechanisms of increment in circulating galectin-3 levels. Our findings highlight cardiac inflammation and enhanced β-adrenoceptor activation in mediating elevated galectin-3 levels via cardiac release in the mechanism.
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Affiliation(s)
- My-Nhan Nguyen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Yidan Su
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Donna Vizi
- Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - Lu Fang
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - Andris H Ellims
- Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - Wei-Bo Zhao
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Helen Kiriazis
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Xiao-Ming Gao
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine Rutgers, New Jersey Medical School, New Jersey, USA
| | - Andrew J Taylor
- Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - Julie R McMullen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Anthony M Dart
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia.,Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - David M Kaye
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia.,Department of Cardiovascular Medicine, the Alfred Hospital, Melbourne, Australia
| | - Xiao-Jun Du
- Baker Heart and Diabetes Institute, Melbourne, Australia. .,Central Clinical School, Monash University, Melbourne, Australia.
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24
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Zhang J, Xing Q, Zhou X, Li J, Li Y, Zhang L, Zhou Q, Tang B. Circulating miRNA‑21 is a promising biomarker for heart failure. Mol Med Rep 2017; 16:7766-7774. [PMID: 28944900 DOI: 10.3892/mmr.2017.7575] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 07/20/2017] [Indexed: 11/05/2022] Open
Abstract
microRNA 21 (miRNA‑21) promotes the development of cardiac fibrosis, hypertrophy and heart failure. However, whether it can be used as a biomarker for the diagnosis and prognosis of heart failure remains unclear. The current study assessed circulating miRNA‑21 as a viable indicator for diagnosis and prognosis of heart failure. The levels of miRNA‑21 and brain natriuretic peptide were measured in serum obtained from the peripheral vein (miRNA‑21‑PV) and coronary sinus (miRNA‑21‑CS) of 80 patients with heart failure and 40 control individuals via reverse transcription‑quantitative polymerase chain reaction and ELISA, respectively. The correlations between circulating miRNA‑21 and diagnosis, severity, prognosis and re‑hospitalization rate of heart failure were evaluated using statistical analysis. Serum miRNA‑21‑PV and miRNA‑21‑CS levels of patients with heart failure were significantly higher than that of control subjects, and were also correlated with ejection fraction and brain natriuretic peptide. Both were determined to have high levels of sensitivity and specificity for diagnosing heart failure. Follow‑up of the patients with heart failure indicated that miRNA‑21‑PV and miRNA‑21‑CS were correlated with prognosis, and miRNA‑21‑CS was efficient in predicting re‑hospitalization for heart failure. Circulating miRNA‑21 has potential to be a biomarker of heart failure.
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Affiliation(s)
- Jianghua Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Qiang Xing
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Xianhui Zhou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Jinxin Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Yaodong Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Lin Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Qina Zhou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
| | - Baopeng Tang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830054, P.R. China
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25
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McAloon CJ, Ali D, Hamborg T, Banerjee P, O'Hare P, Randeva H, Osman F. Extracellular cardiac matrix biomarkers in patients with reduced ejection fraction heart failure as predictors of response to cardiac resynchronisation therapy: a systematic review. Open Heart 2017; 4:e000639. [PMID: 28878953 PMCID: PMC5574440 DOI: 10.1136/openhrt-2017-000639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 06/26/2017] [Accepted: 07/13/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Cardiac resynchronisation therapy (CRT) is an effective therapy for selected patients with heart failure (HF); however, a significant non-response rate exists. We examined current evidence on extracellular cardiac matrix (ECM) biomarkers in predicting response following CRT. METHODS Complete literature review of PubMed, Ovid SP MEDLINE, Cochrane Library and TRIP, reference lists, international cardiology conferences and ongoing studies between December 1999 and December 2015 conducted according to prospectively registered study selection and analysis criteria (PROSPERO:CRD42016025864) was performed. All observational and randomised control trials (RCT) were included if they tested prespecified ECM biomarkers' ability to predict CRT response. Risk of bias assessment and data extraction determined pooling of included studies was not feasible due to heterogeneity of the selected studies. RESULTS A total of 217 studies were screened; six (five prospective cohort and one RCT substudy) were included in analysis with 415 participants in total. Study sizes varied (n=55-260), cohort characteristics contrasted (male: 67.8%-83.6%, ischaemic aetiology: 40.2%-70.3%) and CRT response definitions differed (three clinical/functional, three echocardiographic). Consistent observation in all ECM biomarker behaviour before and after CRT implantation was not observed between studies. Lower type I and type III collagen synthesis biomarkers (N-terminal propeptides of type I and III procollagens) expression demonstrated replicated ability to predict reverse left ventricular remodelling. CONCLUSION Collagen synthesis biomarkers offer the most potential as ECM biomarkers for predicting CRT response. Heterogeneity between these studies was large and limited the ability to pool and compare results numerically. Use of different response definitions was one of the biggest challenges.
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Affiliation(s)
- Christopher J McAloon
- Department of Cardiology, University Hospital Coventry, Coventry, UK
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
| | - Danish Ali
- Department of Cardiology, University Hospital Coventry, Coventry, UK
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
| | - Thomas Hamborg
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
| | - Prithwish Banerjee
- Department of Cardiology, University Hospital Coventry, Coventry, UK
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Life Sciences, Coventry University, Coventry, UK
| | - Paul O'Hare
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
| | - Harpal Randeva
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
| | - Faizel Osman
- Department of Cardiology, University Hospital Coventry, Coventry, UK
- Department of Medicine, Warwick Medical School, University of Warwick, Coventry, UK
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26
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Abstract
Myocardial injury, mechanical stress, neurohormonal activation, inflammation, and/or aging all lead to cardiac remodeling, which is responsible for cardiac dysfunction and arrhythmogenesis. Of the key histological components of cardiac remodeling, fibrosis either in the form of interstitial, patchy, or dense scars, constitutes a key histological substrate of arrhythmias. Here we discuss current research findings focusing on the role of fibrosis, in arrhythmogenesis. Numerous studies have convincingly shown that patchy or interstitial fibrosis interferes with myocardial electrophysiology by slowing down action potential propagation, initiating reentry, promoting after-depolarizations, and increasing ectopic automaticity. Meanwhile, there has been increasing appreciation of direct involvement of myofibroblasts, the activated form of fibroblasts, in arrhythmogenesis. Myofibroblasts undergo phenotypic changes with expression of gap-junctions and ion channels thereby forming direct electrical coupling with cardiomyocytes, which potentially results in profound disturbances of electrophysiology. There is strong evidence that systemic and regional inflammatory processes contribute to fibrogenesis (i.e., structural remodeling) and dysfunction of ion channels and Ca2+ homeostasis (i.e., electrical remodeling). Recognizing the pivotal role of fibrosis in the arrhythmogenesis has promoted clinical research on characterizing fibrosis by means of cardiac imaging or fibrosis biomarkers for clinical stratification of patients at higher risk of lethal arrhythmia, as well as preclinical research on the development of antifibrotic therapies. At the end of this review, we discuss remaining key questions in this area and propose new research approaches. © 2017 American Physiological Society. Compr Physiol 7:1009-1049, 2017.
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Affiliation(s)
- My-Nhan Nguyen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Helen Kiriazis
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Xiao-Ming Gao
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Xiao-Jun Du
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
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27
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AbouEzzeddine OF, McKie PM, Dunlay SM, Stevens SR, Felker GM, Borlaug BA, Chen HH, Tracy RP, Braunwald E, Redfield MM. Suppression of Tumorigenicity 2 in Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2017; 6:JAHA.116.004382. [PMID: 28214792 PMCID: PMC5523750 DOI: 10.1161/jaha.116.004382] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Soluble suppression of tumorigenicity 2 (sST2) receptor is a biomarker that is elevated in certain systemic inflammatory diseases. Comorbidity-driven microvascular inflammation is postulated to play a key role in heart failure with preserved ejection fraction (HFpEF) pathophysiology, but data on how sST2 relates to clinical characteristics or inflammatory conditions or biomarkers in HFpEF are limited. We sought to determine circulating levels and clinical correlates of sST2 in HFpEF. METHODS AND RESULTS At enrollment, patients (n=174) from the Phosphodiesterase-5 Inhibition to Improve Clinical Status And Exercise Capacity in Diastolic Heart Failure (RELAX) trial of sildenafil in HFpEF had sST2 levels measured. Clinical characteristics; cardiac structure and function; exercise performance; and biomarkers of neurohumoral activation, systemic inflammation and fibrosis, and myocardial necrosis were assessed in relation to sST2 levels. Median sST2 levels in male and female HFpEF patients were 36.7 ng/mL (range 30.9-49.2 ng/mL; reference range 4-31 ng/mL) and 30.8 ng/mL (range 25.3-39.3 ng/mL; reference range 2-21 ng/mL), respectively. Among HFpEF patients, higher sST2 levels were associated with the presence of diabetes mellitus; atrial fibrillation; renal dysfunction; right ventricular pressure overload and dysfunction; systemic congestion; exercise intolerance; and biomarkers of systemic inflammation and fibrosis, neurohumoral activation, and myocardial necrosis (P<0.05 for all). sST2 was not associated with left ventricular structure or left ventricular systolic or diastolic function. CONCLUSIONS In HFpEF, sST2 levels were associated with proinflammatory comorbidities, right ventricular pressure overload and dysfunction, and systemic congestion but not with left ventricular geometry or function. These data suggest that ST2 may be a marker of systemic inflammation in HFpEF and potentially of extracardiac origin. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00763867.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Eugene Braunwald
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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28
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Arrigo M, Truong QA, Onat D, Szymonifka J, Gayat E, Tolppanen H, Sadoune M, Demmer RT, Wong KY, Launay JM, Samuel JL, Cohen-Solal A, Januzzi JL, Singh JP, Colombo PC, Mebazaa A. Soluble CD146 Is a Novel Marker of Systemic Congestion in Heart Failure Patients: An Experimental Mechanistic and Transcardiac Clinical Study. Clin Chem 2017; 63:386-393. [DOI: 10.1373/clinchem.2016.260471] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/23/2016] [Indexed: 12/12/2022]
Abstract
Abstract
BACKGROUND
Soluble CD146 (sCD146), is an endothelial marker with similar diagnostic power as natriuretic peptides in decompensated heart failure (HF). While natriuretic peptides are released by the failing heart, sCD146 may be released by veins in response to stretch induced by systemic congestion in HF. This study investigated the source, effects of vascular stress on release and prognostic properties of sCD146 in HF.
METHODS
In a peripheral venous stress study, plasma concentrations of sCD146 and N-terminal probrain natriuretic-peptide (NT-proBNP) were measured in 44 HF patients at baseline and after 90 min of unilateral forearm venous congestion. In addition, sCD146 and NT-proBNP were measured in peripheral vein (PV) and coronary sinus (CS) blood samples of 137 HF patients and the transcardiac gradient was calculated. Those patients were followed for major adverse cardiovascular events (MACE) during 2 years.
RESULTS
The induction of venous stress was associated with a pronounced increase in circulating concentrations of sCD146 in the congested arm (+60 μg/L) compared to the control arm (+16 μg/L, P = 0.025), while no difference in NT-proBNP concentrations was seen. In contrast to positive transcardiac gradient for NT-proBNP, median sCD146 concentrations were lower in CS than in PV (396 vs 434, P < 0.001), indicating a predominantly extracardiac source of sCD146. Finally, increased PV concentrations of sCD146 were associated with higher risk of MACE at 2 years.
CONCLUSIONS
Soluble CD146 is released from the peripheral vasculature in response to venous stretch and may reflect systemic congestion in chronic HF patients.
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Affiliation(s)
- Mattia Arrigo
- INSERM UMR-S 942, Paris, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, France; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, France, Department of Cardiology, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
- Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland
| | - Quynh A Truong
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Duygu Onat
- Division of Cardiology, Columbia University Medical Center, New York NY
| | - Jackie Szymonifka
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Etienne Gayat
- INSERM UMR-S 942, Paris, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, France; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | | | | | - Ryan T Demmer
- Division of Cardiology, Columbia University Medical Center, New York NY
| | - Ka Y Wong
- Division of Cardiology, Columbia University Medical Center, New York NY
| | - Jean Marie Launay
- Université Paris Diderot, PRES Sorbonne Paris Cité, France, Department of Biochemistry, AP-HP, Lariboisière University Hospitals, Paris, France
| | | | - Alain Cohen-Solal
- INSERM UMR-S 942, Paris, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, France, Department of Cardiology, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Paolo C Colombo
- Division of Cardiology, Columbia University Medical Center, New York NY
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France
- Université Paris Diderot, PRES Sorbonne Paris Cité, France; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
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Beaudoin J, Singh JP, Szymonifka J, Zhou Q, Levine RA, Januzzi JL, Truong QA. Novel Heart Failure Biomarkers Predict Improvement of Mitral Regurgitation in Patients Receiving Cardiac Resynchronization Therapy-The BIOCRT Study. Can J Cardiol 2016; 32:1478-1484. [PMID: 27527259 PMCID: PMC5123954 DOI: 10.1016/j.cjca.2016.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 05/19/2016] [Accepted: 05/25/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cardiac resynchronization therapy (CRT) improves mitral regurgitation (MR) in a subset of patients. We hypothesized that biomarkers (amino-terminal pro-B type natriuretic peptide, high-sensitivity troponin I, galectin-3 [gal-3], and soluble ST2) might predict MR response after CRT. METHODS We measured levels of biomarkers during CRT implantation in 132 patients with a subsequent 2-year follow-up. MR was graded as no-trace, mild, moderate, or severe at baseline and at 6 months. RESULTS In patients with baseline at least mild MR, 56% had improvement at 6 months, with lower 2-year mortality vs patients without improvement (0% vs 18%; P = 0.002). At baseline, patients with MR improvement had lower high-sensitivity troponin I and gal-3 levels compared with those without improvement (19 vs 40 pg/L; P = 0.01; 14 vs 18 ng/mL; P = 0.007). In multivariable analyses, higher log-transformed gal-3 (odds ratio, 0.15; 95% confidence interval, 0.04-0.65; P = 0.01) remained an independent predictor for MR nonimprovement. Levels of pro-B type natriuretic peptide and soluble ST2 were lower at follow-up in patients with MR improvement (potentially reflecting reduced myocardial stretch and stress) without reaching statistical significance. CONCLUSIONS Higher galectin levels at the time of CRT implantation are associated with MR nonresponse.
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Affiliation(s)
- Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Québec City, Quebec, Canada; Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jackie Szymonifka
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, New York, USA
| | - Qing Zhou
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert A Levine
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Quynh A Truong
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, New York, USA
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30
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Mohl W, Molnár L, Merkely B. Cardiac Vein Anatomy and Transcoronary Sinus Catheter Interventions in Myocardial Ischemia. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Werner Mohl
- Department of Cardiac Surgery; Medical University of Vienna; Vienna Austria
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31
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Beltrami M, Ruocco G, Dastidar AG, Franci B, Lucani B, Aloia E, Nuti R, Palazzuoli A. Additional value of Galectin-3 to BNP in acute heart failure patients with preserved ejection fraction. Clin Chim Acta 2016; 457:99-105. [DOI: 10.1016/j.cca.2016.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 03/23/2016] [Accepted: 04/06/2016] [Indexed: 12/11/2022]
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32
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Chatterjee NA, Singh JP, Szymonifka J, Deaño RC, Thai WE, Wai B, Min JK, Januzzi JL, Truong QA. Incremental value of cystatin C over conventional renal metrics for predicting clinical response and outcomes in cardiac resynchronization therapy: The BIOCRT study. Int J Cardiol 2015; 205:43-49. [PMID: 26710332 DOI: 10.1016/j.ijcard.2015.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/28/2015] [Accepted: 12/04/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the benefit of CRT in select patients with heart failure (HF), there remains significant need for predicting those at risk for adverse outcomes for this effective but costly therapy. CysC, an emerging marker of renal function, is predictive of worsening symptoms and mortality in patients with HF. This study assessed the utility of baseline and serial measures of cystatin C (CysC), compared to conventional creatinine-based measures of renal function (estimated glomerular filtration rate, eGFR), in predicting clinical outcomes following cardiac resynchronization therapy (CRT). METHODS In 133 patients, we measured peripheral venous (PV) and coronary sinus (CS) CysC concentrations and peripheral creatinine levels at the time of CRT implant. Study endpoints included clinical response to CRT at 6 months and major adverse cardiac events (MACE) at 2 years. RESULTS While all 3 renal metrics were predictive of MACE (all adjusted p ≤ 0.02), only CysC was associated with CRT non-response at 6 months (adjusted odds ratio 3.6, p = 0.02). CysC improved prediction of CRT non-response (p ≤ 0.003) in net reclassification index analysis compared to models utilizing standard renal metrics. Serial CysC > 1mg/L was associated with 6-month CRT non-response and reduced 6-minute walk distance as well as 2-year MACE (all p ≤ 0.04). CONCLUSION In patients undergoing CRT, CysC demonstrated incremental benefit in the prediction of CRT non-response when compared to standard metrics of renal function. Baseline and serial measures of elevated CysC were predictive of CRT non-response and functional status at 6 months as well as long-term clinical outcomes.
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Affiliation(s)
- Neal A Chatterjee
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jagmeet P Singh
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jackie Szymonifka
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, United States
| | - Roderick C Deaño
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, United States
| | - Wai-Ee Thai
- Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Bryan Wai
- Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - James K Min
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, United States
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Quynh A Truong
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, United States.
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van der Velde AR, Lexis CPH, Meijers WC, van der Horst IC, Lipsic E, Dokter MM, van Veldhuisen DJ, van der Harst P, de Boer RA. Galectin-3 and sST2 in prediction of left ventricular ejection fraction after myocardial infarction. Clin Chim Acta 2015; 452:50-7. [PMID: 26528636 DOI: 10.1016/j.cca.2015.10.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/26/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Fibrosis is a pivotal event in infarct repair and progressive remodeling after myocardial infarction (MI). Biomarkers may be used to monitor fibrosis, and therefore we evaluated the predictive value of galectin-3 and sST2 for cardiac remodeling after MI. METHODS Plasma galectin-3 and sST2 were measured in patients admitted with primary percutaneous coronary intervention (PCI) for acute MI, at baseline and at 4months. Left ventricular ejection fraction (LVEF) and infarct size were measured after 4months with cardiac MRI (CMR). RESULTS In total, 247 patients had blood samples and CMR data available (mean age 57.7±11.6years; 79.8% male). Increased baseline galectin-3 (≥17.8ng/mL) identified patients with lower LVEF (50.3% (±9.1) vs. non-elevated galectin-3 55.0% (±8.0); P<0.001), and larger infarct size (13.8g. (±12.9) vs. 8.6g. (±8.7); P=0.002) after 4months. Elevated sST2 (≥35.0ng/mL) did not predict decreased LVEF or larger infarct size. Furthermore we showed that at baseline, galectin-3 was an independent predictor for LVEF (β=-0.18; P=0.005) and infarct size (β=0.18; P=0.004). We repeated the analyses using median values of galectin-3 (13.4ng/mL) and sST2 (30.3ng/mL) as a cut point, and this validated our results. CONCLUSION The fibrosis biomarker galectin-3, but not sST2, taken immediately after MI, predicts LVEF and infarct size after 4months. We hypothesize that galectin-3 may play a role in the pathophysiology of cardiac remodeling after acute MI.
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Affiliation(s)
- A Rogier van der Velde
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Chris P H Lexis
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Wouter C Meijers
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Iwan C van der Horst
- University of Groningen, Department of Critical Care, University Medical Center Groningen, Groningen, the Netherlands
| | - Erik Lipsic
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Martin M Dokter
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Dirk J van Veldhuisen
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Pim van der Harst
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Rudolf A de Boer
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
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Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. J Lipids 2015; 2015:971453. [PMID: 25949827 PMCID: PMC4407625 DOI: 10.1155/2015/971453] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 12/16/2022] Open
Abstract
Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.
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Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, DDU Gorakhpur University, Gorakhpur 273009, India
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35
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Evolving Role of Galectin-3 as a Cardiac Biomarker. JACC-HEART FAILURE 2015; 3:253-6. [DOI: 10.1016/j.jchf.2014.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 12/21/2014] [Indexed: 01/24/2023]
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36
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Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy. J Interv Card Electrophysiol 2015; 43:31-44. [PMID: 25715916 DOI: 10.1007/s10840-015-9982-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/04/2015] [Indexed: 01/03/2023]
Abstract
Circulating biomarkers related to inflammation, neurohormones, myocardial stress, and necrosis have been associated with commonly encountered arrhythmic disorders such as atrial fibrillation (AF) and more malignant processes including ventricular arrhythmias (VA) and sudden cardiac death (SCD). Both direct and indirect biomarkers implicated in the heart failure cascade have potential prognostic value in patients undergoing cardiac resynchronization therapy (CRT). This review will focus on the role of biomarkers in AF, history of SCD, and CRT with an emphasis to improve clinical risk assessment for arrhythmias and patient selection for device therapy. Notably, information obtained from biomarkers may supplement traditional diagnostic and imaging techniques, thus providing an additional benefit in the management of patients.
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37
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López B, González A, Querejeta R, Zubillaga E, Larman M, Díez J. Galectin-3 and histological, molecular and biochemical aspects of myocardial fibrosis in heart failure of hypertensive origin. Eur J Heart Fail 2015; 17:385-92. [DOI: 10.1002/ejhf.246] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research; University of Navarra; Pamplona Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research; University of Navarra; Pamplona Spain
| | - Ramón Querejeta
- Division of Cardiology; Donostia University Hospital, University of the Basque Country San Sebastian; Spain
| | - Elena Zubillaga
- Division of Internal Medicine; Donostia University Hospital, University of the Basque Country San Sebastian; Spain
| | - Mariano Larman
- Division of Cardiology; Donostia University Hospital, University of the Basque Country San Sebastian; Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research; University of Navarra; Pamplona Spain
- Department of Cardiology and Cardiac Surgery; University of Navarra Clinic, University of Navarra; Pamplona Spain
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38
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Dieplinger B, Mueller T. Soluble ST2 in heart failure. Clin Chim Acta 2014; 443:57-70. [PMID: 25269091 DOI: 10.1016/j.cca.2014.09.021] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/27/2014] [Accepted: 09/16/2014] [Indexed: 12/12/2022]
Abstract
In addition to routine clinical laboratory tests (including natriuretic peptides and cardiac troponins), other biomarkers are gaining attention for their utility in heart failure (HF) management. Among them, soluble ST2 (sST2) a novel biomarker integrating inflammation, fibrosis, and cardiac stress has been included in the 2013 ACCF/AHA guideline for additive risk stratification of patients with acute and chronic HF. sST2 is an interleukin-1 (IL-1) receptor family member, is secreted into the circulation and functions as a "decoy" receptor for IL-33, inhibiting IL-33/ST2 signaling. Blood concentrations of sST2 are increased in various diseases such as inflammatory diseases and heart diseases and are considered a valuable prognostic marker in both conditions. sST2 lacks disease specificity and, therefore, is not a valuable marker for the diagnosis of HF. In acute and chronic HF, however, sST2 is strongly associated with measures of HF severity and poor outcome. Several studies in patients with HF indicate that serial measurement of sST2 has prognostic value and could have a potential role in future biomarker-directed therapy. In this review, the role of sST2 as a HF biomarker will be discussed, specifically addressing analytical considerations of measuring sST2 as well as the clinical applications of measurement of sST2 for the diagnosis, prognosis and monitoring of acute and chronic HF.
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Affiliation(s)
- Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
| | - Thomas Mueller
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria
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