Specific biomarkers of myocardial inflammation and remodeling processes as predictors of mortality in high‐risk patients undergoing percutaneous mitral valve repair (MitraClip)

Dörr, Oliver; Walther, Claudia; Liebetrau, Christoph; Keller, Till; Tabert, Hannes; Boeder, Niklas; Bayer, Matthias; Bauer, Pascal; Möllmann, Helge; Gaede, Luise; Troidl, Christian; Voss, Sandra; Bauer, Timm; Hamm, Christian W.; Nef, Holger

doi:10.1002/clc.22900

Cited by 11 publications

(9 citation statements)

References 32 publications

(103 reference statements)

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“…Inflammation plays a key role in the pathogenesis of cardiovascular disease (CVD), and recently inflammation has become a direct target of therapy for CVD prevention . High‐sensitivity C‐reactive protein (hsCRP), a marker of systemic inflammation, has been shown to be associated with incident CVD events .…”

Section: Introductionmentioning

confidence: 99%

“…Obtained through nuclear magnetic resonance (NMR) spectroscopy, GlycA reflects the serum concentration and glycosylation state of five major acute phase inflammatory proteins (α1-acid glycoprotein, haptoglobin, α1-antitrypsin, α1-antichymotrypsin, and transferrin). 1 Inflammation plays a key role in the pathogenesis of cardiovascular disease (CVD), [2][3][4] and recently inflammation has become a direct target of therapy for CVD prevention. [5][6][7] High-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation, has been shown to be associated with incident CVD events.…”

Section: Introductionmentioning

confidence: 99%

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Associations of ideal cardiovascular health with GlycA, a novel inflammatory marker: The Multi‐Ethnic Study of Atherosclerosis

Benson

Tibuakuu

Zhao

et al. 2018

Clinical Cardiology

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Background: Unhealthy lifestyles and inflammation contribute to cardiovascular disease (CVD). GlycA is a novel biomarker of systemic inflammation representing posttranslational glycosylation of acute phase reactants and associated with increased clinical CVD risk. Hypothesis: We hypothesized that ideal cardiovascular health (CVH), as assessed by (higher) Life’s Simple Seven (LS7) scores, would be associated with lower GlycA levels among individuals free of CVD in a multi-ethnic community-based population. Methods: This was a cross-sectional study of 6,479 MESA participants [53% women; mean age 62±10 years] with GlycA levels measured at baseline by NMR spectroscopy. The LS7 metrics (smoking, physical activity, diet, body mass index, blood pressure, cholesterol, and glucose) were each scored as ideal (2), moderate (1), or poor (0). Total scores were summed and categorized as optimal (12–14), average (8–11) and inadequate (0–7). Linear regression assessed percent difference in GlycA by LS7 scores, after adjusting for age, sex, ethnicity, education, income, family history of CVD and other inflammatory biomarkers. Results: GlycA levels were 403.4±63.1, 374.4±59.2 and 350.3±56.2 micromoles per liter (μmol/L) for inadequate, average, and optimal CVH, respectively (p-trend<0.001). After multivariable adjustment, GlycA remained independently and inversely associated with CVH categories, with a lower mean GlycA level of 5 μmol/L (95% CI 4.5–5.8) for each 1unit increment in LS7 score. Conclusions: Among this group of ethnically-diverse individuals without CVD, suboptimal CVH is associated with higher GlycA levels, independent of traditional inflammatory biomarkers. Strategies aimed at improving CVH might reduce GlycA, which could be a marker of reduced risk of future CVD events.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations of ideal cardiovascular health with GlycA, a novel inflammatory marker: The Multi‐Ethnic Study of Atherosclerosis

Benson

Tibuakuu

Zhao

et al. 2018

Clinical Cardiology

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“…In particular, increased collagen synthesis in the myocardium, along with its impaired degradation in response to pressure and volume overload, leads to collagen accumulation within the heart, causing structural remodeling, myocardial stiffness, and brosis [23,24]. Indeed, biomarkers of myocardial in ammation and ECM remodeling, such as MMPs, have previously been shown to be important predictors of mortality [25].…”

Section: Discussionmentioning

confidence: 99%

Serum levels of matrix metalloproteinases MMP-2, MMP-3, MMP-9 and tissue inhibitor of matrix metalloproteinase TIMP-2 in patients with myocarditis.

Kobusiak−Prokopowicz

Kaaz

Marciniak

et al. 2021

Preprint

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Background: Under physiological conditions, the myocardial extracellular matrix (ECM) is maintained by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). However, certain stimuli cause the upregulation of MMPs, which can lead to pathological remodeling of the ECM. We assessed serum levels of MMPs and TIMP-2 in patients with myocarditis and their relationship(s) to myocardial damage.Methods: In total, 45 patients with myocarditis who underwent cardiac magnetic resonance imaging were included, comprising 11 with concurrent chronic kidney disease (CKD). Blood samples were obtained to assess serum levels of MMP-2, MMP-3, MMP-9, and TIMP-2. Results: Serum MMP-2, MMP-3, and TIMP-2 levels negatively correlated with ejection fraction values in patients with myocarditis, while MMP-3 levels correlated with longitudinal deformation (p<0.05). Serum MMP-2, MMP-3, and TIMP-2 levels also negatively correlated with renal function, as assessed by the estimated glomerular filtration rate (p<0.05). Patients with myocarditis and concurrent CKD had higher levels of MMP-2 and TIMP-2 than those without kidney damage.Conclusions:1. We demonstrated serum MMP-2, MMP-3, and TIMP-2 concentrations were related to left ventricular ejection fraction, and MMP-3 levels correlated with longitudinal deformation, indicating MMPs play an important role in the post-inflammatory remodeling of the myocardium.2. The occurrence of other heart diseases was an important element in modifying the relationship between MMPs and the degree of myocardial damage.3. Chronic kidney damage in patients with myocarditis results in increased MMP activity. A negative correlation between eGFR and MMP-2, MMP-3 and TIMP-2, and a positive correlation between creatinine and MMP-3 levels, underlines the role of fibrosis in myocarditis with concomitant chronic kidney disease.

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“…Of note, a lower galectin-3 level was a predictor of MR improvement after cardiac resynchronization therapy (CRT) [52]. In addition, biomarkers reflecting inflammation (hsCRP, interleukin-6) and cardiac remodeling processes (matrix metalloproteinases (MMP-2 and MMP-9)) were associated with a higher risk of mortality following the procedure [53]. The highly sensitive troponin T showed strong prognostic power in predicting survival after transcatheter MV repair, with an accuracy comparable to that of a mid-regional proANP level [35].…”

Section: Nps and Other Biomarkersmentioning

confidence: 99%

Functional Role of Natriuretic Peptides in Risk Assessment and Prognosis of Patients with Mitral Regurgitation

Gallo

Forte

Stanzione

et al. 2020

JCM

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The management of mitral valve regurgitation (MR), a common valve disease, represents a challenge in clinical practice, since the indication for either surgical or percutaneous valve replacement or repair are guided by symptoms and by echocardiographic parameters which are not always feasible. In this complex scenario, the use of natriuretic peptide (NP) levels would serve as an additive diagnostic and prognostic tool. These biomarkers contribute to monitoring the progression of the valve disease, even before the development of hemodynamic consequences in a preclinical stage of myocardial damage. They may contribute to more accurate risk stratification by identifying patients who are more likely to experience death from cardiovascular causes, heart failure, and cardiac hospitalizations, thus requiring surgical management rather than a conservative approach. This article provides a comprehensive overview of the available evidence on the role of NPs in the management, risk evaluation, and prognostic assessment of patients with MR both before and after surgical or percutaneous valve repair. Despite largely positive evidence, a series of controversial findings exist on this relevant topic. Recent clinical trials failed to assess the role of NPs following the interventional procedure. Future larger studies are required to enable the introduction of NP levels into the guidelines for the management of MR.

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Specific biomarkers of myocardial inflammation and remodeling processes as predictors of mortality in high‐risk patients undergoing percutaneous mitral valve repair (MitraClip)

Abstract: The present study is the first to identify biomarkers reflecting inflammation (hsCRP, IL-6) and cardiac remodeling processes (MMP-2, MMP-9) as predictors of mortality in high-risk patients undergoing PMVR.

Cited by 11 publications

References 32 publications

Associations of ideal cardiovascular health with GlycA, a novel inflammatory marker: The Multi‐Ethnic Study of Atherosclerosis

Associations of ideal cardiovascular health with GlycA, a novel inflammatory marker: The Multi‐Ethnic Study of Atherosclerosis

Serum levels of matrix metalloproteinases MMP-2, MMP-3, MMP-9 and tissue inhibitor of matrix metalloproteinase TIMP-2 in patients with myocarditis.

Functional Role of Natriuretic Peptides in Risk Assessment and Prognosis of Patients with Mitral Regurgitation

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