1
|
Ricci F, Larsson A, Ruge T, Galanti K, Hamrefors V, Sutton R, Olshansky B, Fedorowski A, Johansson M. Orthostatic hypotension is associated with higher levels of circulating endostatin. EUROPEAN HEART JOURNAL OPEN 2024; 4:oeae030. [PMID: 38708290 PMCID: PMC11068211 DOI: 10.1093/ehjopen/oeae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024]
Abstract
Aims The pathophysiology of orthostatic hypotension (OH), a common clinical condition, associated with adverse outcomes, is incompletely understood. We examined the relationship between OH and circulating endostatin, an endogenous angiogenesis inhibitor with antitumour effects proposed to be involved in blood pressure (BP) regulation. Methods and results We compared endostatin levels in 146 patients with OH and 150 controls. A commercial chemiluminescence sandwich immunoassay was used to measure circulating levels of endostatin. Linear and multivariate logistic regressions were conducted to test the association between endostatin and OH. Endostatin levels were significantly higher in OH patients (59 024 ± 2513 pg/mL) vs. controls (44 090 ± 1978pg/mL, P < 0.001). A positive linear correlation existed between endostatin and the magnitude of systolic BP decline upon standing (P < 0.001). Using multivariate analysis, endostatin was associated with OH (adjusted odds ratio per 10% increase of endostatin in the whole study population = 1.264, 95% confidence interval 1.141-1.402), regardless of age, sex, prevalent cancer, and cardiovascular disease, as well as traditional cardiovascular risk factors. Conclusion Circulating endostatin is elevated in patients with OH and may serve as a potential clinical marker of increased cardiovascular risk in patients with OH. Our findings call for external validation. Further research is warranted to clarify the underlying pathophysiological mechanisms.
Collapse
Affiliation(s)
- Fabrizio Ricci
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
- Department of Neuroscience, Imaging and Clinical Sciences, ‘G.d'Annunzio’ University of Chieti-Pescara, Chieti, Italy
- Heart Department, ‘SS Annunziata’ Polyclinic University Hospital, Chieti, Italy
| | - Anders Larsson
- Section of Clinical Chemistry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Toralph Ruge
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Kristian Galanti
- Department of Neuroscience, Imaging and Clinical Sciences, ‘G.d'Annunzio’ University of Chieti-Pescara, Chieti, Italy
| | - Viktor Hamrefors
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden, Jan Waldenströms gata 15, 214 28 Malmö, Sweden
| | - Richard Sutton
- Department of Cardiology, Hammersmith Hospital, National Heart and Lung Institute, Imperial College, London, UK
| | - Brian Olshansky
- Division of Cardiology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Madeleine Johansson
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden, Jan Waldenströms gata 15, 214 28 Malmö, Sweden
| |
Collapse
|
2
|
A Comparison between Endostatin and Conventional Biomarkers on 30-Day Mortality and Renal Replacement Therapy in Unselected Intensive Care Patients. Biomedicines 2021; 9:biomedicines9111603. [PMID: 34829832 PMCID: PMC8615500 DOI: 10.3390/biomedicines9111603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 12/05/2022] Open
Abstract
Endostatin may predict mortality and kidney impairment in general populations as well as in critically ill patients. We decided to explore the possible role of endostatin as a predictor of 30-day mortality, acute kidney injury (AKI), and renal replacement therapy (RRT) in a cohort of unselected intensive care unit (ICU) patients. Endostatin and creatinine in plasma were analyzed and SAPS3 was determined in 278 patients on ICU arrival at admission to a Swedish medium-sized hospital. SAPS3 had the highest predictive value, 0.85 (95% C.I.: 0.8–0.90), for 30-day mortality. Endostatin, in combination with age, predicted 30-day mortality by 0.76 (95% C.I.: 0.70–0.82). Endostatin, together with age and creatinine, predicted AKI with 0.87 (95% C.I.: 0.83–0.91). Endostatin predicted AKI with [0.68 (0.62–0.74)]. Endostatin predicted RRT, either alone [0.82 (95% C.I.: 0.72–0.91)] or together with age [0.81 (95% C.I.: 0.71–0.91)]. The predicted risk for 30-day mortality, AKI, or RRT during the ICU stay, predicted by plasma endostatin, was not influenced by age. Compared to the complex severity score SAPS3, circulating endostatin, combined with age, offers an easily managed option to predict 30-day mortality. Additionally, circulating endostatin combined with creatinine was closely associated with AKI development.
Collapse
|
3
|
Fernlund E, Gyllenhammar T, Jablonowski R, Carlsson M, Larsson A, Ärnlöv J, Liuba P. Serum Biomarkers of Myocardial Remodeling and Coronary Dysfunction in Early Stages of Hypertrophic Cardiomyopathy in the Young. Pediatr Cardiol 2017; 38:853-863. [PMID: 28361263 PMCID: PMC5388706 DOI: 10.1007/s00246-017-1593-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 02/21/2017] [Indexed: 12/21/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) remains the leading cause of sudden cardiac death in the young. Early markers for HCM are important to identify individuals at risk. The aim of this study was to investigate novel serum biomarkers reflecting myocardial remodeling, microfibrosis, and vascular endotheliopathy in the early stages of familial HCM in young patients. Twenty-three HCM patients, 16 HCM-risk individuals, and 66 controls (median 15 years) underwent echocardiography and serum analysis for cathepsin S, endostatin, myostatin, type I collagen degradation marker (ICTP), matrix metalloproteinase (MMP)-9, vascular endothelial growth factor receptor (VEGFR)-1, and vascular and intercellular adhesion molecules (VCAM, ICAM). In a subset of the population, global myocardial perfusion was performed by magnetic resonance imaging. Cathepsin S (p = 0.0009), endostatin (p < 0.0001), MMP-9 (p = 0.008), and VCAM (p = 0.04) were increased in the HCM group and correlated to left ventricular mass index and mitral E/e' (p < 0.01). In the HCM-risk group, myostatin was decreased (p = 0.004), whereas ICAM was increased (p = 0.002). Global perfusion was decreased in the HCM group (p < 0.05) versus controls. Endostatin and mitral E/e' correlated inversely to myocardial perfusion (p ≤ 0.05). This is the first study demonstrating adverse changes in biomarkers reflecting myocardial matrix remodeling, microfibrosis, and vascular endotheliopathy in early stage of hypertrophic cardiomyopathy in the young.
Collapse
Affiliation(s)
- E. Fernlund
- Pediatric Heart Center, Skane University Hospital, Lund University, Lund, Sweden ,Department of Paediatrics, Linköping University Hospital, Linköping University, Linköping, Sweden
| | - T. Gyllenhammar
- Department of Clinical Sciences, Lund University Hospital, Lund University, Lund, Sweden
| | - R. Jablonowski
- Department of Clinical Sciences, Lund University Hospital, Lund University, Lund, Sweden
| | - M. Carlsson
- Department of Clinical Sciences, Lund University Hospital, Lund University, Lund, Sweden
| | - A. Larsson
- grid.8993.bDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - J. Ärnlöv
- grid.8993.bDepartment of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden ,grid.4714.6Department of Neurobiology, Division of Family Medicine and Primary Care, Care Science and Society, Karolinska Institutet, Huddinge, Sweden
| | - P. Liuba
- Pediatric Heart Center, Skane University Hospital, Lund University, Lund, Sweden
| |
Collapse
|