Elevated extracellular HSP70 (HSPA1A) level as an independent prognostic marker of mortality in patients with heart failure

Abstract

Predicting the survival of a patient with heart failure (HF) is a complex problem in clinical practice. Our previous study reported that extracellular HSP70 (HSPA1A) correlates with markers of heart function and disease severity in HF, but the predictive value of HSP70 is unclear. The goal of this study was to analyze extracellular HSP70 as predictive marker of mortality in HF. One hundred ninetyfive patients with systolic heart failure were enrolled and followed up for 60 months. By the end of follow-up, 85 patients were alive (survivors) and 110 died (nonsurvivors). HSP70 (measured by ELISA in the serum) was elevated in nonsurvivors, compared with survivors (0.39 [0.27-0.59] vs. 0.30 [0.24-0.43] ng/ml, respectively, p = 0.0101). In Kaplan-Meier survival analysis higher HSP70 levels above median were associated with a significantly increased mortality. In multivariable survival models, we show that HSP70 level above the median is an age-, sex-, body mass index-, creatinine-, and NT-proBNP-independent predictor of 5-year mortality in HF. Extracellular HSP70 could prove useful for estimating survival in patients with HF.

Differential expression of myocardial heat shock proteins in rats acutely exposed to fluoride

“…The values represent mean ± SD (n = 3). *p < 0.05 significantly different from control, + p < 0.05 significantly different from 45 mg F − -treated rats (one-way ANOVA followed by Tukey's multiple comparison test) Earlier studies showed that elevated extracellular levels of Hsp70 serve as a prognostic marker for inflammatory cytokine-mediated immune response and the progression of heart failure in patients with acute AMI (Jenei et al 2013;Satoh et al 2006). Our results are in accordance with the report of Chattopadhyay et al (2011).…”

The detection and role of heat shock protein 70 in various nondisease conditions and disease conditions: a literature review

“…Therefore, the major detection methods for HSP70 have included extracellular fluid-based enzyme-linked immunosorbent assays (ELISAs) (Jenei et al 2013a;Rejdak et al 2012;Chebotareva et al 2014;Agnew 2011;Cui et al 2015) for plasma and immunofluorescence (Cui et al 2015), western blotting (Cui et al 2015), qRT-PCR (Gómez-Chocoa 2014), and flow cytometry (Cui et al 2015;Agnew 2011;Gómez-Chocoa 2014) for plasma or urine, as well as immunohistochemical analysis Gehrmann et al 2014a;Omar et al 1990) of various tissues and cells. ELISA is an optimized method for detecting serum concentrations of HSP70.…”

“…Regardless, predicting the survival of a patient with heart failure (HF) and the prognoses of comatose postcardiac arrest patients are complex problems in clinical practice. In Kaplan-Meier survival analyses, HSP70 levels greater than the median were associated with significantly increased mortality, and multivariate survival models have shown that HSP70 levels greater than the median are an independent predictor of 5-year mortality in HF (Jenei et al 2013a). However, extracellular HSP70 levels are significantly decreased in survivors, whereas they persist in nonsurvivors, predicting 30-day mortality regardless of age, sex, complications, or APAC HE II score (Jenei et al 2013b).…”

Useful tests to assess the clinical usefulness of new prognostic markers: the example of heart failure

“…A tanulmányainkban a többváltozós Cox regressziós elemzések azt mutatták, hogy mind az RDW, mind a HSP70 szignifi káns, független prognosztikai marker krónikus szívelégtelenségben szenvedő betegek túlélésére vonatkozóan. Az első elemzésben az RDW kapcsolatot mutatott a betegek egyéves túlélésével [14], míg a másodikban a HSP70 mutatott kapcsolatot az öt-éves túléléssel [15].…”

“…A vizsgálatok részletes leírása, az alkalmazott mérési és analitikai módszerek ismertetése a korábbi közlemények-ben találhatók [14,15].…”