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Biomarker Profiles in Heart Failure Patients With Preserved and Reduced Ejection Fraction
University of Groningen, Netherlands.
University of Groningen, Netherlands; Academic Medical Centre, Netherlands.
University of Groningen, Netherlands.
University of Groningen, Netherlands; Carl von Ossietzky University of Oldenburg, Germany.
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2017 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 6, no 4, article id e003989Article in journal (Refereed) Published
Abstract [en]

Background-Biomarkers may help us to unravel differences in the underlying pathophysiology between heart failure (HF) patients with a reduced ejection fraction (HFrEF) and a preserved ejection fraction (HFpEF). Therefore, we compared biomarker profiles to characterize pathophysiological differences between patients with HFrEF and HFpEF. Methods and Results-We retrospectively analyzed 33 biomarkers from different pathophysiological domains (inflammation, oxidative stress, remodeling, cardiac stretch, angiogenesis, arteriosclerosis, and renal function) in 460 HF patients (21% HFpEF, left ventricular ejection fraction amp;gt;= 45%) measured at discharge after hospitalization for acute HF. The association between these markers and the occurrence of all-cause mortality and/or HF-related rehospitalizations at 18 months was compared between patients with HFrEF and HFpEF. Patients were 70.6 +/- 11.4 years old and 37.4% were female. Patients with HFpEF were older, more often female, and had a higher systolic blood pressure. Levels of high-sensitive C-reactive protein were significantly higher in HFpEF, while levels of pro-atrial-type natriuretic peptide and N-terminal pro-brain natriuretic peptide were higher in HFrEF. Linear regression followed by network analyses revealed prominent inflammation and angiogenesis-associated interactions in HFpEF and mainly cardiac stretch-associated interactions in HrEF. The angiogenesis-specific marker, neuropilin and the remodeling-specific marker, osteopontin were predictive for all-cause mortality and/or HF-related rehospitalizations at 18 months in HFpEF, but not in HFrEF (P for interaction amp;lt;0.05). Conclusions-In HFpEF, inflammation and angiogenesis- mediated interactions are predominantly observed, while stretch-mediated interactions are found in HFrEF. The remodeling marker osteopontin and the angiogenesis marker neuropilin predicted outcome in HFpEF, but not in HFrEF.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 6, no 4, article id e003989
Keywords [en]
biomarker; heart failure; multimarker; pathophysiology
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-139640DOI: 10.1161/JAHA.116.003989ISI: 000404098500005PubMedID: 28360225OAI: oai:DiVA.org:liu-139640DiVA, id: diva2:1133706
Note

Funding Agencies|Netherlands Heart Foundation [2000Z003]; Biosite France SAS, Jouy-en-Josas, France; Roche Diagnostics Nederland BV, Venlo, the Netherlands; Novartis PharmaBV, Arnhem, the Netherlands; BG Medicine Inc, Waltham, MA

Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2017-11-29

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