Relaxin levels in pulmonary hypertension: A comparison between pulmonary arterial hypertension and diastolic heart failure-induced pulmonary hypertension

Mazurek, Jeremy A.; Horne, Benjamin D.; Kelesidis, Iosif; Salamon, Jason N.; Zolty, Ronald

doi:10.1016/j.healun.2012.11.030

Cited by 10 publications

(13 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…discharge (area under the curve: 0.816, 95% CI 0.724-0.909). 11 Mazurek et al 12 found higher levels of relaxin in patients with pulmonary hypertension. It is of note, however, that the populations included in these studies were very different from that of the current RELAHF study.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

The relationship of circulating relaxin‐2 concentrations with short‐term prognosis in patients with acute heart failure: the RELAHF study

Herrero‐Puente

Prieto

García-García

et al. 2017

European J of Heart Fail

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

“…showed that relaxin concentrations predicted the development of severe cardiovascular events within 180 days of hospital discharge (area under the curve: 0.816, 95% CI 0.724–0.909) . Mazurek et al . found higher levels of relaxin in patients with pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 98%

The relationship of circulating relaxin‐2 concentrations with short‐term prognosis in patients with acute heart failure: the RELAHF study

Herrero‐Puente

Prieto

García-García

et al. 2017

European J of Heart Fail

View full text Add to dashboard Cite

“…20 In another study of patients with pulmonary arterial hypertension, diastolic HF, or diastolic HFinduced pulmonary hypertension, median relaxin levels measured from the pulmonary artery or peripheral vein were not increased in patients with diastolic HF or diastolic HF-induced pulmonary hypertension compared with healthy control subjects. 33 Relaxin levels were increased in those with pulmonary arterial hypertension, with some correlation to pulmonary vascular resistance and right ventricular dysfunction.…”

Section: Expression In Heart Failurementioning

confidence: 96%

“…Regardless of whether relaxin concentrations are increased, taking into consideration the results of the studies by Dschietzig et al, 14 Kupari et al, 20 and Mazurek et al, 33 the source of relaxin in HF appears to be cardiac and possibly pulmonary, and at least partially mediated by flow and filling pressures. 34…”

Section: Expression In Heart Failurementioning

confidence: 99%

Relaxin for the Treatment of Acute Decompensated Heart Failure

Goland

Elkayam

2016

Cardiology in Review

View full text Add to dashboard Cite

Acute heart failure remains a major cause of morbidity, and its treatment requires an increasing investment of the health care system. Whereas success in treating chronic heart failure has been achieved over the last decades, several pharmacological approaches for acute heart failure have been introduced but have failed to demonstrate any clinical benefit. Serelaxin is a recombinant human relaxin-2 vasoactive peptide that causes systemic and renal vasodilation. Data suggest that the clinical benefits may be attributable to a potential combination of multiple actions of serelaxin, including improving systemic, cardiac, and renal hemodynamics, and protecting cells and organs from damage via neurohormonal, anti-inflammatory, antiremodeling, antifibrotic, anti-ischemic, and proangiogenic effects. Recently, a number of clinical trials have demonstrated that serelaxin infusion over 48 hours improved dyspnea with more rapid relief of congestion during the first days after admission for heart failure. In addition, administration of serelaxin diminished cardiac, renal, and hepatic damage, which were associated with improved long-term mortality. Available data support substantial clinical benefits and significant promise for serelaxin as a treatment option for patients with acute heart failure. This review focuses on the pharmacology and mechanisms of action of serelaxin and provides a detailed discussion of the clinical evidence for this novel therapy in acute heart failure.

show abstract

“…In line with the promising results of serelaxin clinical trials in HF, increasing evidence suggests a role for endogenous relaxin in HF pathophysiology. The hypothesis of a compensatory up‐regulation of the relaxin system in states of PH and of a role for this system in the modulation of pulmonary vasculature is compelling based on the available evidence, but further studies are needed to corroborate it. Better understanding of the role of endogenous relaxin in the pathophysiology of acute and chronic HF may be of great value in terms of expanding the therapeutic use of serelaxin in this context.…”

mentioning

confidence: 99%

Reply

Pintalhao

Castro-Chaves

Bettencourt

2017

European J of Heart Fail

View full text Add to dashboard Cite

ReplyWe read with great interest the research letter from Emmens et al. 1 and thank the authors for their comments on our recently published paper in this journal. 2 Emmens et al. evaluated relaxin circulating levels in a cohort of patients with heart failure (HF) with preserved ejection fraction (HFpEF) and pulmonary hypertension (PH) and found no association between relaxin groups and echocardiographically or invasively determined intracardiac pressures. 1 These results do not extend our recent findings that relaxin circulating levels were associated with clinical and echocardiographic markers of volume overload, PH and right heart dysfunction and overload in a population of acute HF patients. 2 Several differences between the study populations are worth noting and may help to elucidate the differences between the results of the two studies. We evaluated relaxin levels at admission in a population of patients with acute HF, including both patients with HFpEF and those with HF with reduced ejection fraction. 2 These patients were heterogeneous with respect to the degree of volume overload, volume distribution and echocardiographic parameters of chamber dimensions and function, which allowed us to establish different patterns of pulmonary pressures and right heart overload among relaxin groups. 2 In the study by Emmens et al., 1 all patients had chronic HFpEF with established PH. This patient selection criterion may, on one hand, have hindered the establishment of differences in pulmonary and right heart pressures between groups. However, on the other hand, it supports our hypothesis of increased relaxin secretion to circulation in states of PH as relaxin levels in these patients (median: 82.3 pg/mL) 1 were higher than have .been described in most previous studies addressing relaxin levels in HF, including our own. The lack of relaxin levels below the detection limit of the assay, 1 unlike in our study in which levels were undetectable in about 25% of patients, 2 also strengthens this hypothesis.In line with the promising results of serelaxin clinical trials in HF, 3,4 increasing evidence suggests a role for endogenous relaxin in HF pathophysiology. The hypothesis of a compensatory up-regulation of the relaxin system in states of PH and of a role for this system in the modulation of pulmonary vasculature is compelling based on the available evidence, 2,4,5 but further studies are needed to corroborate it. Better understanding of the role of endogenous relaxin in the pathophysiology of acute and chronic HF may be of great value in terms of expanding the therapeutic use of serelaxin in this context. References1. Emmens JE, ter Maaten JM, Voors AA. Are circulating relaxin levels related to pulmonary hypertension in patients with heart failure? Eur J Heart Fail 2017;19:958-960. 2. Pintalhao M, Castro-Chaves P, Vasques-Novoa F, Goncalves F, Mendonca L, Fontes-Carvalho R, Lourenco P, Almeida P, Leite-Moreira A, Bettencourt P. Relaxin serum levels in acute heart failure are associated with pulmonary hypertension and rig...

show abstract

Relaxin levels in pulmonary hypertension: A comparison between pulmonary arterial hypertension and diastolic heart failure-induced pulmonary hypertension

Cited by 10 publications

References 6 publications

The relationship of circulating relaxin‐2 concentrations with short‐term prognosis in patients with acute heart failure: the RELAHF study

The relationship of circulating relaxin‐2 concentrations with short‐term prognosis in patients with acute heart failure: the RELAHF study

Relaxin for the Treatment of Acute Decompensated Heart Failure

Reply

Contact Info

Product

Resources

About