Biomarkers in Heart Failure

Braunwald, Eugene

doi:10.1056/nejmra0800239

Cited by 1,126 publications

(932 citation statements)

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“…Thus, inflammatory proteins and cytokines have been proposed as new emerging CVD risk factors. 4 Similarly, other studies have shown that elevated concentrations of adipokines and chemokines seem to have a key role in the pathogenesis of type-2 diabetes that leads to a low-grade inflammation status. 5 C-reactive protein (CRP) has been highlighted as one of the most powerful predictors of CVD risk in adults 6 and children.…”

Section: Introductionmentioning

confidence: 93%

Associations of physical activity, cardiorespiratory fitness and fatness with low-grade inflammation in adolescents: the AFINOS Study

et al. 2010

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Objective: To examine the independent associations of objectively measured physical activity (PA), cardiorespiratory fitness (CRF) and fatness with low-grade inflammatory markers in adolescents. Design: Cross-sectional study in Spain. Subjects: A sample of 192 adolescents aged 13-17 years. Measurements: PA was assessed with an accelerometer for 7 days. A 20-m shuttle-run test was used to assess CRF. Skinfold thicknesses at six sites and WCs were measured. BMI was calculated from measured height and weight. C-reactive protein (CRP), interleukin-6 (IL-6) and complement factors C3 and C4 were assayed. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Regression analysis adjusted for potential confounders and HOMA-IR was used to determine the associations between PA, CRF and fatness with low-grade inflammatory markers. Results: Total PA, vigorous PA and MVPA were positively associated with CRF (r ¼ 0.25-0.48), whereas vigorous PA was negatively associated with skinfolds (r ¼ À0.27). CRF was inversely associated with fatness, (r ¼ À0.30 to À0.48). CRF and fatness were inversely and positively associated with HOMA-IR (r ¼ À0.16 and 0.21, respectively). PA variables were not independently associated with inflammatory markers. CRF and fatness were inversely and positively associated with CRP, C3 and C4, respectively. Only body fat explained a relevant amount of the variance of the model in CRP (4%) and C4 (19%), whereas CRP and body fat jointly explained the variance in C3 (25%). All these observations were independent of HOMA-IR. Conclusions: These findings support the key role of CRF and fatness on low-grade inflammation, as well as the possible indirect role of habitual PA through CRF and body fat in adolescents.

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Section: Introductionmentioning

confidence: 93%

Associations of physical activity, cardiorespiratory fitness and fatness with low-grade inflammation in adolescents: the AFINOS Study

et al. 2010

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“…It has been proposed that a heightened pro‐inflammatory state may play a role in the progression of HF, including acute decompensations 1, 2, 3, 4, 5, 6, 7, 8, 9. Impairment of nitric oxide bioavailability due to oxidative stress, leading to impaired cyclic guanosine monophosphate‐protein kinase G signaling29 is one potential mechanism underlying the link between inflammation and HF progression.…”

Section: Introductionmentioning

confidence: 99%

Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction

Abernethy

Raza

Sun

et al. 2018

JAHA

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BackgroundUnderlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro‐inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD‐HFpEF) compared with patients with stable HFpEF (S‐HFpEF).Methods and ResultsUsing a post hoc analysis the serum biomarkers tumor necrosis factor‐alpha, high‐sensitivity C‐reactive protein interleukin 6 and pentraxin 3 (PTX3) and clinical, demographic, echocardiographic‐Doppler and clinical outcomes data were analyzed in HFpEF patients enrolled in NHLBI Heart Failure Research Network clinical trials which enrolled patients with either AD‐HFpEF or S‐HFpEF. Compared to S‐HFpEF, AD‐HFpEF patients had higher levels of PTX3 (3.08 ng/mL versus 1.27 ng/mL, P<0.0001), interleukin‐6 (4.14 pg/mL versus 1.71 pg/mL, P<0.0001), tumor necrosis factor‐alpha (11.54 pg/mL versus 8.62 pg/mL, P=0.0015), and high‐sensitivity C‐reactive protein (11.90 mg/dL versus 3.42 mg/dL, P<0.0001). Moreover, high‐sensitivity C‐reactive protein, interleukin‐6 and PTX3 levels were significantly higher in AD‐HFpEF compared with S‐HFpEF patients admitted for decompensated HF within the previous year. PTX3 was positively correlated with left atrial volume index (r=0.41, P=0.0017) and left ventricular mass (r=0.26, P=0.0415), while tumor necrosis factor‐alpha was inversely correlated with E/A ratio (r=−0.31, P=0.0395).ConclusionsLevels of pro‐inflammatory biomarkers are strikingly higher in AD‐HFpEF compared with S‐HFpEF patients. PTX3 and tumor necrosis factor‐alpha are correlated with echocardiographic‐Doppler evidence of diastolic dysfunction. Taken together these data support the concept that a heightened pro‐inflammatory state has a pathophysiologic role in the development of AD‐HFpEF.

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“…Los péptidos de tipo B son los únicos biomarcadores realmente establecidos en la práctica clínica en la IC 53 . Actualmente, se recomienda su utilización para excluir otras alternativas como causa de disnea y para obtener información pronóstica (Recomendación Clase IIa -Nivel de Evidencia C) 54 .…”

Section: Utilidad Clínicaunclassified