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Biomarker profiles in heart failure patients with preserved and reduced ejection fraction
Tromp, Jasper Khan, Mohsin A.F. Klip, IJsbrand T. Meyer, Sven de Boer, Rudolf A. Jaarsma, Tiny Hillege, Hans L. van Veldhuisen, Dirk J. van der Meer, Peter Voors, Adriaan A.
Tromp, Jasper
Khan, Mohsin A.F.
Klip, IJsbrand T.
Meyer, Sven
de Boer, Rudolf A.
Jaarsma, Tiny
Hillege, Hans L.
van Veldhuisen, Dirk J.
van der Meer, Peter
Voors, Adriaan A.
Abstract
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 ≥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 inHFpEF and mainly cardiac stretch-associated interactions in HFrEF. 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 < 0.05). Conclusions-In HFpEF, inflammation and angiogenesis-mediated interactions are predominantly observed, while stretchmediated interactions are found in HFrEF. The remodeling marker osteopontin and the angiogenesis marker neuropilin predicted outcome in HFpEF, but not in HFrEF.
Keywords
biomarker, heart failure, multimarker, pathophysiology
Date
2017
Type
Journal article
Journal
Journal of the American Heart Association
Book
Volume
6
Issue
4
Page Range
1-25
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled