Pentraxin 3 Is a New Inflammatory Marker Correlated With Left Ventricular Diastolic Dysfunction and Heart Failure With Normal Ejection Fraction

Matsubara, Junichi; Sugiyama, Seigo; Nozaki, Toshimitsu; Sugamura, Koichi; Konishi, Masaaki; Ohba, Keisuke; Matsuzawa, Yasushi; Akiyama, Eiichi; Yamamoto, Eiichiro; Sakamoto, Kenji; Nagayoshi, Yasuhiro; Kaikita, Koichi; Sumida, Hitoshi; Kim‐Mitsuyama, Shokei; Ogawa, Hisao

doi:10.1016/j.jacc.2010.10.018

Cited by 163 publications

(149 citation statements)

References 10 publications

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“…Left atrial volume index is a relatively robust measure of diastolic function as it is less acutely load‐sensitive than various Doppler derived indexes. The correlation between PTX3 and left atrial volume may be related to the fact that this relatively recently described biomarker has a strong association with myocardial fibrosis and, consistent with the endothelial inflammation hypothesis, is strongly expressed by vascular endothelium 21, 22, 23, 53. Whether PTX3 truly has a specific pathophysiologic role in HF is not known.…”

Section: Discussionmentioning

confidence: 97%

“…More recently, the contribution of a pro‐inflammatory state to the pathophysiology of HFpEF has been emphasized 6, 8, 17, 23, 31, 34, 35, 36, 45. In patients with ADHF, biomarkers reflecting activation of the renin‐angiotensin aldosterone system (RAAS) (plasma renin activity, aldosterone levels), oxidative stress (uric acid) and collagen synthesis (N‐terminal procollagen III) appear to be elevated to a similar extent in HFrEF and HFpEF 33.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have revealed a significant correlation between elevations in blood levels of pro‐inflammatory biomarkers such as tumor necrosis factor alpha (TNF‐α), C‐reactive protein (CRP),interleukin 6 (IL‐6), and HF severity and prognosis 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20. Recently, pentraxin 3 (PTX3), an acute‐phase reactant member of the CRP super family expressed by a variety of cell types in response to various inflammatory stimuli21 and thought to be a marker of vascular inflammation, was found to facilitate risk stratification of HF patients 22, 23, 24, 25, 26. Other pro‐inflammatory biomarkers that may have prognostic value in HF include galectin‐3 and ST2 27, 28…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…These findings accentuate the role inflammation plays in both female HFpEF and pre‐eclampsia and suggest the possible use of C‐reactive protein in cardiovascular risk screening in pregnancies complicated by hypertension. The inflammatory component of HFpEF has been mentioned previously,10, 101 with for example IL‐6, TNF‐α, interleukin receptors, and pentraxin 3 as potential HFpEF biomarkers 10, 102, 103, 104, 105. To our knowledge, gender‐specific data on this topic are currently lacking; thus with our women‐only designed search, we probably overlooked a number of studies on inflammatory markers in HFpEF.…”

Section: Discussionmentioning

confidence: 97%

Shared biomarkers between female diastolic heart failure and pre‐eclampsia: a systematic review and meta‐analysis

et al. 2017

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Evidence accumulates for associations between hypertensive pregnancy disorders and increased cardiovascular risk later. The main goal of this study was to explore shared biomarkers representing common pathogenic pathways between heart failure with preserved ejection fraction (HFpEF) and pre‐eclampsia where these biomarkers might be potentially eligible for cardiovascular risk stratification in women after hypertensive pregnancy disorders. We sought for blood markers in women with diastolic dysfunction in a first literature search, and through a second search, we investigated whether these same biochemical markers were present in pre‐eclampsia.This systematic review and meta‐analysis presents two subsequent systematic searches in PubMed and EMBASE. Search I yielded 3014 studies on biomarkers discriminating women with HFpEF from female controls, of which 13 studies on 11 biochemical markers were included. Cases had HFpEF, and controls had no heart failure. The second search was for studies discriminating women with pre‐eclampsia from women with non‐hypertensive pregnancies with at least one of the biomarkers found in Search I. Search II yielded 1869 studies, of which 51 studies on seven biomarkers were included in meta‐analyses and 79 studies on 12 biomarkers in systematic review.Eleven biological markers differentiated women with diastolic dysfunction from controls, of which the following 10 markers differentiated women with pre‐eclampsia from controls as well: C‐reactive protein, HDL, insulin, fatty acid‐binding protein 4, brain natriuretic peptide, N terminal pro brain natriuretic peptide, adrenomedullin, mid‐region pro adrenomedullin, cardiac troponin I, and cancer antigen 125.Our study supports the hypothesis that HFpEF in women shares a common pathogenic background with pre‐eclampsia. The biomarkers representing inflammatory state, disturbances in myocardial function/structure, and unfavourable lipid metabolism may possibly be eligible for future prognostic tools.

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“…According to certain authors, PTX3 may have a prognostic role in HF. Matsubara et al [5] demonstrated that PTX3 is an independent marker of left ventricular (LV) diastolic dysfunction in HF with preserved ejection fraction (EF), and that myocardium may contribute to increased concentration of this protein in the blood.…”

Section: Introductionmentioning

confidence: 99%

Supplementation with omega-3 acids after myocardial infarction and modification of inflammatory markers in light of the patients’ diet: a preliminary study

et al. 2017

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A b s t r a c tBackground: Neuroendocrine activation, activation of proinflammatory cytokines and platelets, and endothelial dysfunction play a significant role in the development of heart failure (HF). Aim:The aim of the work was to assess the effect of supplementation with EPA and DHA in a daily dose of 1 g on selected inflammatory markers and platelet activation in patients with HF after recent myocardial infarction in light of their diet. Methods:This preliminary study was a randomised, double-blind trial involving 30 patients with post-infarction HF. One group received a product containing 1 g of omega-3 acids, while the other received placebo, i.e. corn oil 1 g daily for 12 weeks. At baseline and at week 12, venous blood was obtained in the fasted state in order to determine the following parameters: NT-proBNP, fibrinogen, INR, creatinine clearance, serum lipid profile, hsCRP, troponin, glucose, transaminases, GGTP, MCP-1, pentraxin 3, and CD-40. To evaluate the patient's diet and dietary intake of omega-3 acids, a 24-h dietary interview and the Block's Food Frequency Questionnaire (FFQ) were applied.Results: Supplementation of omega-3 acids in a dose of 1 g per day had no effect on lipid or inflammatory parameters, with the exception of pentraxin 3. In both groups, after three months of supplementation, overall consumption of energy and saturated fatty acids was significantly higher (p < 0.05). Conclusions:Potential benefits associated with supplementation were nullified by a highly atherogenic diet. Apparently, supplementation of omega-3 acids without simultaneous dietary education and nutrition control does not bring the expected effect. Further research involving a larger group of patients is needed to better understand the relationship between patient's diet and the effectiveness of omega-3 supplementation.

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Pentraxin 3 Is a New Inflammatory Marker Correlated With Left Ventricular Diastolic Dysfunction and Heart Failure With Normal Ejection Fraction

Cited by 163 publications

References 10 publications

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

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

Shared biomarkers between female diastolic heart failure and pre‐eclampsia: a systematic review and meta‐analysis

Supplementation with omega-3 acids after myocardial infarction and modification of inflammatory markers in light of the patients’ diet: a preliminary study

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