Discriminative Utility of Apelin-to-NT-Pro-Brain Natriuretic Peptide Ratio for Heart Failure with Preserved Ejection Fraction among Type 2 Diabetes Mellitus Patients

Abstract

Background: Apelin is a regulatory vasoactive peptide, which plays a pivotal role in adverse cardiac remodeling and heart failure (HF) with reduced ejection fraction. The purpose of the study was to investigate whether serum levels of apelin is associated with HF with preserved election fraction (HFpEF) in patients with T2DM. Methods: The study retrospectively involved 101 T2DM patients aged 41 to 62 years (48 patients with HFpEF and 28 non-HFpEF patients). The healthy control group consisted of 25 individuals with matched age and sex. Data collection included demographic and anthropometric information, hemodynamic performances and biomarkers of the disease. Transthoracic B-mode echocardiography, Doppler and TDI were performed at baseline. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and apelin were measured by ELISA in all patients at the study entry. Results: Unadjusted multivariate logistic model yielded the only apelin to NT-proBNP ratio (OR = 1.44; p = 0.001), BMI > 34 кг/м2 (OR = 1.07; p = 0.036), NT-proBNP > 458 pmol/mL (OR = 1.17; p = 0.042), LAVI > 34 mL/m2 (OR = 1.06; p = 0.042) and E/e’ > 11 (OR = 1.04; p = 0.044) remained to be strong predictors for HFpEF. After obesity adjustment, multivariate logistic regression showed that the apelin to NT-proBNP ratio < 0.82 × 10−2 units remained sole independent predictor for HFpEF (OR = 1.44; 95% CI: 1.18–2.77; p = 0.001) HFpEF in T2DM patients. In conclusion, we found that apelin to NT-proBNP ratio < 0.82 × 10−2 units better predicted HFpEF in T2DM patients than apelin and NT-proBNP alone. This finding could open new approach for CV risk stratification of T2DM at higher risk of HF.

Circulating Myokines as Novel Biomarkers for Cardiovascular Diseases

“…ELISA was used to measure serum N terminal pro-B-type natriuretic peptide (NT-proBNP) and AP levels in all patients. The AP to NT-proBNP ratio was a better predictor of HFpEF in T2DM patients than AP or NT-proBNP alone [ 98 ]. Additionally, the prognostic value of AP levels has been investigated in CHF children.…”

Nghiên Cứu Tình Hình Suy Tim Phân Suất Tống Máu Bảo Tồn Ở Bệnh Nhân Đái Tháo Đường Típ 2 Có Tăng Huyết Áp Tại Bệnh Viện Đa Khoa Trung Ương Cần Thơ Năm 2021-2022

“…Berezin AA, Fushtey IM, Berezin AE khi nghiên cứu NT Pro BNP huyết tương ở bệnh nhân đái tháo đường típ 2 có biến chứng suy tim phân suất tống máu bảo tồn nhận thấy dãn nhĩ (T) là một trong các yếu tố liên quan với HFpEF (OR là 1,2; p<0,05) [6]. Có lẽ độ cứng của cơ tim (titin), chất nền ngoại bào (xơ hóa), trương lực cơ tim, hình thái buồng tim ảnh hưởng rõ rệt chức năng tâm trương thất (T) trong suy tim phân suất tống máu bảo tồn do tăng áp lực đổ đầy tâm trương.…”

Interplay between Myokine Profile and Glycemic Control in Type 2 Diabetes Mellitus Patients with Heart Failure

“…Previous studies reported that both T2DM patients and HF patients had lower concentrations of irisin than do healthy individuals, whereas data on the alteration of circulating levels of apelin, myostatin and adropin in chronic HF patients depending on the presence of T2DM remain controversial [ 10 , 11 , 12 , 13 ]. However, there is evidence of the fact that irisin and apelin have yielded prognostic values for HFpEF regardless of NPs [ 14 , 15 ]. It is still uncertain whether altered glycemic control in T2DM patients with chronic HF corresponds to a difference in circulating levels of these myokines and whether the myokine profile should be considered as a marker of advanced disease.…”