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Takvorian KS, Wang D, Courchesne P, Vasan RS, Benjamin EJ, Cheng S, Larson MG, Levy D, Ho JE. The Association of Protein Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction. Circ Heart Fail 2023; 16:e009446. [PMID: 36475777 PMCID: PMC9937440 DOI: 10.1161/circheartfailure.121.009446] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) are distinct clinical entities, yet there is scant evidence for associations of proteomic signatures with future development of HFpEF versus HFrEF. METHODS We evaluated the association of 71 protein biomarkers with incident HFpEF versus HFrEF (left ventricular ejection fraction ≥ versus <50%) among Framingham Heart Study participants using multivariable Cox models. RESULTS Among 7038 participants (mean age 49 years; 54% women), 5 biomarkers were associated with increased risk of incident HFpEF (false discovery rate q<0.05): NT-proBNP (N-terminal pro-B-type natriuretic peptide; hazard ratio [HR], 2.13; 95% CI, 1.52-2.99; P<0.001), growth differentiation factor-15 (HR, 1.67; 95% CI, 1.32-2.12; P<0.001), adrenomedullin (HR, 1.58; 95% CI, 1.23-2.04; P<0.001), uncarboxylated matrix Gla protein (HR, 1.55; 95% CI 1.23-1.95; P<0.001), and C-reactive protein (HR, 1.46; 95% CI, 1.17-1.83; P=0.001). Fourteen biomarkers were associated with incident HFrEF (multivariable P<0.001, q<0.05 for all). Of these, 3 biomarkers were associated with both HF subtypes (NT-proBNP, growth differentiation factor-15, and C-reactive protein). When compared directly, myeloperoxidase, resistin, and paraoxanase-1 were more strongly associated with HFrEF than HFpEF. CONCLUSIONS We identified 5 protein biomarkers of new-onset HFpEF representing pathways of inflammation, cardiac stress, and vascular stiffness, which partly overlapped with HFrEF. We found 14 biomarkers associated with new-onset HFrEF, with some distinct associations including myeloperoxidase, resistin, and paraoxanase-1. Taken together, these findings provide insights into similarities and differences in the development of HF subtypes. REGISTRATION URL: https://clinicaltrials.gov/ct2/show/NCT00005121; Unique identifier: NCT0005121.
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Affiliation(s)
| | - Dongyu Wang
- Cardiovascular Institute and Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Paul Courchesne
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Ramachandran S. Vasan
- Department of Medicine and Boston University School of Medicine, Boston, MA
- Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Boston, MA
- The Framingham Heart Study, Framingham, MA
- Department of Epidemiology and Boston University School of Public Health, Boston, MA
| | - Emelia J. Benjamin
- Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Boston, MA
- The Framingham Heart Study, Framingham, MA
- Department of Epidemiology and Boston University School of Public Health, Boston, MA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai, Los Angeles, CA
| | - Martin G. Larson
- The Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, MA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Jennifer E. Ho
- Cardiovascular Institute and Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
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Dadarlat-Pop A, Pop D, Procopciuc L, Sitar-Taut A, Zdrenghea D, Bodizs G, Tomoaia R, Gurzau D, Fringu F, Susca-Hojda S, Buzoianu AD. Leptin, Galectin-3 and Angiotensin II Type 1 Receptor Polymorphism in Overweight and Obese Patients with Heart Failure - Role and Functional Interplay. Int J Gen Med 2021; 14:1727-1737. [PMID: 33994803 PMCID: PMC8114101 DOI: 10.2147/ijgm.s301285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background and Aims Leptin, one of the best-known adipocytes, together with the renin-angiotensin-aldosterone system and galectin-3 are important players in inflammation, arterial hypertension and heart failure pathophysiology. Moreover, uninucleotide A1166C polymorphism is associated with hypertension and poor prognosis in heart failure. The aim of the study was to investigate a possible relationship between leptin serum values, specific heart failure biomarkers and the presence of AT1 receptor A1166C polymorphism in overweight and obese heart failure patients. Methods The study included 88 consecutive overweight and obese patients admitted for decompensated heart failure. NT-proBNP, MR-proANP, galectin-3 and leptin levels were determined on the arrival day. Genotyping of the A1166C allele – AT1 receptor gene was performed in all patients in order to find variants. Results We found a strong positive correlation (r = 0.347, p = 0.001) between leptin serum concentrations and BMI. Leptin levels were not correlated with heart failure biomarkers (NT-proBNP, MR-proANP and galectin-3). All homozygote CC variants were hypertensive, but we registered no significant difference in genetic AC and AA variants distribution between hypertensive and normotensive. Leptin was not significantly modified by the presence of potentially pathogenic A1166C–AT 1 receptor genotypes (AC + CC). But, galectin-3 was found in higher concentrations in patients with heterozygous and homozygous A1166C mutations. Conclusion Overweight and obese patients with heart failure display high leptin serum levels. Leptin does not offer incremental prognostic value in heart failure overweight and obese patients. But, galectin-3 was found in higher concentrations in patients with heterozygous and homozygous A1166C mutations, suggesting a worse prognosis probably due to more advanced cardiac fibrosis.
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Affiliation(s)
- Alexandra Dadarlat-Pop
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Pop
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania
| | - Lucia Procopciuc
- Department of Medical Biochemistry, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adela Sitar-Taut
- 4th Medical Clinic, Department of Internal Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dumitru Zdrenghea
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania
| | - Gyorgy Bodizs
- Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania
| | - Raluca Tomoaia
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Gurzau
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florina Fringu
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Silvana Susca-Hojda
- Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca D Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Martin SS, Blaha MJ, Muse ED, Qasim AN, Reilly MP, Blumenthal RS, Nasir K, Criqui MH, McClelland RL, Hughes-Austin JM, Allison MA. Leptin and incident cardiovascular disease: the Multi-ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2015; 239:67-72. [PMID: 25574859 PMCID: PMC4331218 DOI: 10.1016/j.atherosclerosis.2014.12.033] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/06/2014] [Accepted: 12/08/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Higher serum leptin levels have been associated with a modestly higher incidence of cardiovascular disease in studies involving mostly Caucasian men. We aimed to assess the hypothesis that higher baseline levels of serum leptin are associated with higher risk of future cardiovascular disease in a diverse cohort. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) is a modern, community-based, ethnically-diverse, and sex-balanced prospective cohort study of US adults free from cardiovascular disease. Serum leptin was measured in an ancillary study in 2002-2005. This analysis included 1905 MESA participants with baseline leptin and incident cardiovascular event data. Leptin levels were modeled as a log-transformed continuous variable and multivariable-adjusted Cox regression was performed for the primary outcome of hard cardiovascular disease, including coronary heart disease and stroke. RESULTS The median follow-up was 7.6 years (25th-75th 7.1-8.3) with 7051 and 6738 person-years of follow-up in women and men. A hard cardiovascular disease event occurred in 47 women and 63 men. The age- and ethnicity-adjusted hazard ratio estimates for a 1 standard deviation increase in ln(leptin) were 1.16 in women (95% CI 0.78-1.73, p = 0.46) and 0.91 (95% CI 0.69-1.20, p = 0.51) in men. Pooling sexes, and adjusting for sex in addition to age and ethnicity, estimates were 0.98 (95% CI 0.78-1.23, p = 0.89). With additional adjustment for cardiovascular risk factors, the results remained nonsignificant: 0.87 (95% CI 0.68-1.11, p = 0.26). CONCLUSION In conclusion, in a modern, US prospective cohort study of multi-ethnic women and men of multi-ethnic backgrounds, leptin levels are not associated with incident cardiovascular events.
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Affiliation(s)
- Seth S Martin
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Evan D Muse
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Scripps Translational Science Institute, La Jolla, CA, USA
| | - Atif N Qasim
- Division of Cardiology, University of California San Francisco, San Francisco, CA, USA
| | - Muredach P Reilly
- Division of Cardiology, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Khurram Nasir
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA; Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami, FL, USA; Department of Medicine, Herbert Wertheim College of Medicine, University Park, FL, USA; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Michael H Criqui
- Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Jan M Hughes-Austin
- Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Matthew A Allison
- Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
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Gan XT, Ettinger G, Huang CX, Burton JP, Haist JV, Rajapurohitam V, Sidaway JE, Martin G, Gloor GB, Swann JR, Reid G, Karmazyn M. Probiotic administration attenuates myocardial hypertrophy and heart failure after myocardial infarction in the rat. Circ Heart Fail 2014; 7:491-9. [PMID: 24625365 DOI: 10.1161/circheartfailure.113.000978] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Probiotics are extensively used to promote gastrointestinal health, and emerging evidence suggests that their beneficial properties can extend beyond the local environment of the gut. Here, we determined whether oral probiotic administration can alter the progression of postinfarction heart failure. METHODS AND RESULTS Rats were subjected to 6 weeks of sustained coronary artery occlusion and administered the probiotic Lactobacillus rhamnosus GR-1 or placebo in the drinking water ad libitum. Culture and 16s rRNA sequencing showed no evidence of GR-1 colonization or a significant shift in the composition of the cecal microbiome. However, animals administered GR-1 exhibited a significant attenuation of left ventricular hypertrophy based on tissue weight assessment and gene expression of atrial natriuretic peptide. Moreover, these animals demonstrated improved hemodynamic parameters reflecting both improved systolic and diastolic left ventricular function. Serial echocardiography revealed significantly improved left ventricular parameters throughout the 6-week follow-up period including a marked preservation of left ventricular ejection fraction and fractional shortening. Beneficial effects of GR-1 were still evident in those animals in which GR-1 was withdrawn at 4 weeks, suggesting persistence of the GR-1 effects after cessation of therapy. Investigation of mechanisms showed a significant increase in the leptin:adiponectin plasma concentration ratio in rats subjected to coronary ligation, which was abrogated by GR-1. Metabonomic analysis showed differences between sham control and coronary artery ligated hearts particularly with respect to preservation of myocardial taurine levels. CONCLUSIONS The study suggests that probiotics offer promise as a potential therapy for the attenuation of heart failure.
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Affiliation(s)
- Xiaohong Tracey Gan
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Grace Ettinger
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Cathy X Huang
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Jeremy P Burton
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - James V Haist
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Venkatesh Rajapurohitam
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - James E Sidaway
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Glynn Martin
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Gregory B Gloor
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Jonathan R Swann
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Gregor Reid
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.)
| | - Morris Karmazyn
- From the Departments of Physiology and Pharmacology (X.T.G., C.X.H., J.V.H., V.R., M.K.), Microbiology and Immunology (G.E., J.P.B., G.R.), Surgery (J.P.B., G.R.), and Biochemistry (G.B.G.), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Ontario, Canada (G.E., J.P.B., G.B.G., G.R.); and Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom (J.E.S., G.M., J.R.S.).
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