Predictive Values of Apelin for Myocardial Fibrosis in Hypertrophic Cardiomyopathy

Abstract

Apelin was proved to attenuate cardiac interstitial fibrosis. However, the association between apelin level and myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) is still unclear. This study aims to determine whether apelin is associated with myocardial fibrosis in HCM and investigate the predictive values of apelin for myocardial fibrosis in HCM. One hundred sixteen patients with HCM were enrolled in this study. Plasma apelin-13 and high-sensitivity cardiac troponin I (cTNI) were measured. The cardiac systolic and diastolic functions were evaluated by echocardiography, and the presence and extent of cardiac fibrosis were assessed by cardiac magnetic resonance. All statistical data were analyzed by SPSS version 21.0. The percentage of late gadolinium enhancement (LGE) was negatively correlated with apelin and positively correlated with cTNI, maximum wall thickness (MWT), and left ventricular mass index in the overall patients with HCM and LGE. Apelin, cTNI, MWT, and left ventricular ejection fraction were independent predictors of the presence of LGE. The cutoff values of apelin, cTNI, and MWT were 1.24 pg/mL, 0.031 ng/mL, and 19 mm, respectively, for the prediction of LGE. The combined measurements of MWT "19 mm and/or apelin ! 1.24 pg/mL, as well as the combined measurements of MWT "19 mm and/or cTNI "0.031 ng/mL, obtained higher specificity and higher sensitivity, thus, indicating the presence of LGE. Plasma apelin and cTNI are independent predictors of myocardial fibrosis. The combined measurements of serum apelin and MWT, as well as cTNI and MWT, showed higher predictive values for predicting myocardial fibrosis in patients with HCM.

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

“…Additionally, we also found that the LGE% was independently associated with MWT, which is consistent with the results of several previous studies [14,27,34] . As the presence of LGE could be observed especially in areas of ventricular hypertrophy in HCM patients [35], the correlation between MWT and myocardial brosis is considered reasonable.…”

“…Speci cally, in line with the study by Kawasaki et al [16] our study excluded patients with LVEF < 50%, whereas the other two studies did not [14,15]. Additionally, previous studies usually used the visual scoring or semiquantitative scoring method [14,27], and the 2SD thresholding method was used in Kawasaki's study [16]. The current study used a semi-quantitatively grey-scale threshold method (6SD), previously shown to yield improved interobserver variability, reproducibility and precision with regards to LGE, as well as stronger correlations with histopathology in HCM patients [23,28].…”

Predictive Values of Multiple Non-Invasive Markers for Myocardial Fibrosis in Hypertrophic Cardiomyopathy Patients With&nbsp;Preserved Ejection Fraction

“…Additionally, we also found that the LGE% was independently associated with MWT, which is consistent with the results of several previous studies 14,25,33 . As the presence of LGE could be observed especially in areas of ventricular hypertrophy in HCM patients 34 , the correlation between MWT and myocardial fibrosis is considered reasonable.…”

“…Specifically, in line with the study by Kawasaki et al 16 our study excluded patients with LVEF < 50%, whereas another study did not 15 . Additionally, previous studies usually used the visual scoring or semiquantitative scoring method 14,25 , and the 2SD thresholding method was used in Kawasaki's study 16 . The current study used a semi-quantitatively grey-scale threshold method (6SD), previously shown to yield improved interobserver variability, reproducibility and precision with regards to LGE, as well as stronger correlations with histopathology in HCM patients 26,27 .…”

Levels of Apelin-12, AT1R, and AGT are correlated with degree of renal fibrosis in patients with immunoglobulin A nephropathy

“…A decrease in the level of Apelin-12 indicates the decline of kidney function and EMT of renal tubular cells, and progression of fibrosis in the interstitium (13)(14)(15)(16). The ROC curve results in this study show that the peptides Apelin-12, AT1R, and AGT are all sensitive to the judgment of T 0 -T 1 T 2 , and the AUC is greater than 0.7 in predicting T 0 -T 1 T 2 for Apelin-12, AT1R, and AGT.…”