Biomarkers in Heart Failure With Preserved Ejection Fraction: An Update on Progress and Future Challenges

Carnes, Jonathan; Gordon, Gary

doi:10.1016/j.hlc.2019.05.180

Cited by 17 publications

(13 citation statements)

References 76 publications

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“…The patho-physiology of chronic HF includes involvement of six major axes: neurohormonal activation, inflammation, oxidative stress, cardiomyocyte injury, cardiac remodeling and renal dysfunction, represented by different biomarkers (Richards 2018). Cardiac remodeling biomarkers which are currently supported with relevant evidence regarding their monitoring and prognostic accuracy in chronic HF include: the soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1 (Chow et al 2017;Carnes and Gordon 2020). None of them has, however, reached diagnostic potential of brain natriuretic peptide (BNP).…”

Section: Introductionmentioning

confidence: 99%

“…Growth differentiation factor (GDF)-15 is a stressresponsive cytokine, belonging to the transforming growth factor-beta (TGF-β) receptor family and is physiologically expressed in the placenta and the central nervous system (Carnes and Gordon 2020). However, in pathological conditions such as hypoxia, ischemia, oxidative stress or inflammation it may be expressed in various tissues, including the heart, where it was shown to exert anti-hypertrophic properties (Mueller et al 2015).…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Remodeling Biomarkers as Potential Circulating Markers of Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction

Mitić¹,

Stojanović

Ilic

et al. 2020

Tohoku J. Exp. Med.

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Soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1 represent biomarkers of cardiac remodeling, involved in heart failure (HF) progression. We hypothesize that their plasma concentrations, together with brain natriuretic peptide (BNP), are different in HF stratified by ejection fraction (EF), demonstrating correlations with echocardiographic parameters that indicate left ventricular (LV) hypertrophy; LV mass index (LVMI) and posterior wall and septum diameters. HF patients (n = 77) were classified according to EF: reduced EF < 40% (HFrEF), mid-range EF = 40-49% (HFmrEF), preserved EF > 50% (HFpEF). We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p < 0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p = 0. 002), galectin-3 (p < 0.001), GDF-15 (p = 0.011), and syndecan-1 (p = 0.006), whereas galectin-3 correlated after multivariable adjustments (p = 0.001). Independent correlates of septum and posterior wall diameters, in HFpEF, were sST2 (p = 0.019; p = 0.026), galectin-3 (p = 0.011; p = 0.009), GDF-15 (p = 0.007; p = 0.001), and syndecan-1 (p = 0.005; p = 0.002). In HFrEF, only sST2, adjusted, correlated with LVMI (p = 0.010), whereas BNP correlated with LVMI (p = 0.002) and EF (p = 0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p = 0.046) and HFrEF (p = 0.024). Cardiac remodeling biomarkers are potential circulating indicators of LV hypertrophy in HFpEF, which may ensure timely recognition of disease progression among high-risk patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiac Remodeling Biomarkers as Potential Circulating Markers of Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction

Mitić¹,

Stojanović

Ilic

et al. 2020

Tohoku J. Exp. Med.

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“…In the cohort by deBoer et al The risk of HFpEF increased in asymptomatic patients with elevated BNP levels 9,10 . Likewise, elevated levels of NT-proBNP were able to predict patient mortality in patients with decompensated acute HfpEF 11 . All over the world, numerous studies have been developed about the clinical use of NT-proBNP.…”

Section: Discussionmentioning

confidence: 93%

Prognostic of NT-proBNP in heart failure patients with preserved, mid and reduced ejection fraction

Gonella

Batista

Gutiérrez

et al. 2021

cysa

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Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).

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“…Among them, there are several molecules reflecting the processes of inflammation and fibrosis (most notably galectin-3 and soluble suppression of tumorigenesis-2), extracellular matrix remodelling (such as matrix metalloproteinases 2 and 9, carboxy-terminal telopeptide of collagen type I and aminoterminal propeptide of type III procollagen), elevated ventricular wall tension (adrenomedullin), and a vast array of other biomarkers including growth differentiation factor-15, cystatin C, resistin, cancer antigen-125 and von Willebrand factor. 8 Many studies have been conducted with the challenging goals of establishing the diagnostic performance of these biomarkers. In this issue of the Journal, this body of literature is critically reappraised, stressing methodological issues that could affect the reliability of their conclusions.…”

Section: This Article Refers To 'Risk Of Bias In Studies Investigatinmentioning

confidence: 99%

Searching for diagnostic biomarkers of heart failure with preserved ejection fraction: methodological issues

Aimo

Georgiopoulos

Senni

et al. 2020

European J of Heart Fail

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Biomarkers in Heart Failure With Preserved Ejection Fraction: An Update on Progress and Future Challenges

Cited by 17 publications

References 76 publications

Cardiac Remodeling Biomarkers as Potential Circulating Markers of Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction

Cardiac Remodeling Biomarkers as Potential Circulating Markers of Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction

Prognostic of NT-proBNP in heart failure patients with preserved, mid and reduced ejection fraction

Searching for diagnostic biomarkers of heart failure with preserved ejection fraction: methodological issues

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