Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction
BackgroundUnderlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro‐inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD‐HFpEF) compared with patients with sta...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-04-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.007385 |
| _version_ | 1831812559940878336 |
|---|---|
| author | Abraham Abernethy Sadi Raza Jie‐Lena Sun Kevin J. Anstrom Russell Tracy Johannes Steiner Peter VanBuren Martin M. LeWinter |
| author_facet | Abraham Abernethy Sadi Raza Jie‐Lena Sun Kevin J. Anstrom Russell Tracy Johannes Steiner Peter VanBuren Martin M. LeWinter |
| author_sort | Abraham Abernethy |
| collection | DOAJ |
| description | BackgroundUnderlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro‐inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD‐HFpEF) compared with patients with stable HFpEF (S‐HFpEF). Methods and ResultsUsing a post hoc analysis the serum biomarkers tumor necrosis factor‐alpha, high‐sensitivity C‐reactive protein interleukin 6 and pentraxin 3 (PTX3) and clinical, demographic, echocardiographic‐Doppler and clinical outcomes data were analyzed in HFpEF patients enrolled in NHLBI Heart Failure Research Network clinical trials which enrolled patients with either AD‐HFpEF or S‐HFpEF. Compared to S‐HFpEF, AD‐HFpEF patients had higher levels of PTX3 (3.08 ng/mL versus 1.27 ng/mL, P<0.0001), interleukin‐6 (4.14 pg/mL versus 1.71 pg/mL, P<0.0001), tumor necrosis factor‐alpha (11.54 pg/mL versus 8.62 pg/mL, P=0.0015), and high‐sensitivity C‐reactive protein (11.90 mg/dL versus 3.42 mg/dL, P<0.0001). Moreover, high‐sensitivity C‐reactive protein, interleukin‐6 and PTX3 levels were significantly higher in AD‐HFpEF compared with S‐HFpEF patients admitted for decompensated HF within the previous year. PTX3 was positively correlated with left atrial volume index (r=0.41, P=0.0017) and left ventricular mass (r=0.26, P=0.0415), while tumor necrosis factor‐alpha was inversely correlated with E/A ratio (r=−0.31, P=0.0395). ConclusionsLevels of pro‐inflammatory biomarkers are strikingly higher in AD‐HFpEF compared with S‐HFpEF patients. PTX3 and tumor necrosis factor‐alpha are correlated with echocardiographic‐Doppler evidence of diastolic dysfunction. Taken together these data support the concept that a heightened pro‐inflammatory state has a pathophysiologic role in the development of AD‐HFpEF. |
| first_indexed | 2024-12-22T21:38:38Z |
| format | Article |
| id | doaj.art-7f49c8a3a9214b67a79a0c2d29ed8f07 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:38:38Z |
| publishDate | 2018-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7f49c8a3a9214b67a79a0c2d29ed8f072022-12-21T18:11:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-04-017810.1161/JAHA.117.007385Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection FractionAbraham Abernethy0Sadi Raza1Jie‐Lena Sun2Kevin J. Anstrom3Russell Tracy4Johannes Steiner5Peter VanBuren6Martin M. LeWinter7The Cardiology Unit, University of Vermont, Burlington, VTThe Cardiology Unit, University of Vermont, Burlington, VTDuke Clinical Research Institute, Durham, NCDuke Clinical Research Institute, Durham, NCDepartment of Pathology, University of Vermont, Burlington, VTThe Cardiology Unit, University of Vermont, Burlington, VTThe Cardiology Unit, University of Vermont, Burlington, VTThe Cardiology Unit, University of Vermont, Burlington, VTBackgroundUnderlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro‐inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD‐HFpEF) compared with patients with stable HFpEF (S‐HFpEF). Methods and ResultsUsing a post hoc analysis the serum biomarkers tumor necrosis factor‐alpha, high‐sensitivity C‐reactive protein interleukin 6 and pentraxin 3 (PTX3) and clinical, demographic, echocardiographic‐Doppler and clinical outcomes data were analyzed in HFpEF patients enrolled in NHLBI Heart Failure Research Network clinical trials which enrolled patients with either AD‐HFpEF or S‐HFpEF. Compared to S‐HFpEF, AD‐HFpEF patients had higher levels of PTX3 (3.08 ng/mL versus 1.27 ng/mL, P<0.0001), interleukin‐6 (4.14 pg/mL versus 1.71 pg/mL, P<0.0001), tumor necrosis factor‐alpha (11.54 pg/mL versus 8.62 pg/mL, P=0.0015), and high‐sensitivity C‐reactive protein (11.90 mg/dL versus 3.42 mg/dL, P<0.0001). Moreover, high‐sensitivity C‐reactive protein, interleukin‐6 and PTX3 levels were significantly higher in AD‐HFpEF compared with S‐HFpEF patients admitted for decompensated HF within the previous year. PTX3 was positively correlated with left atrial volume index (r=0.41, P=0.0017) and left ventricular mass (r=0.26, P=0.0415), while tumor necrosis factor‐alpha was inversely correlated with E/A ratio (r=−0.31, P=0.0395). ConclusionsLevels of pro‐inflammatory biomarkers are strikingly higher in AD‐HFpEF compared with S‐HFpEF patients. PTX3 and tumor necrosis factor‐alpha are correlated with echocardiographic‐Doppler evidence of diastolic dysfunction. Taken together these data support the concept that a heightened pro‐inflammatory state has a pathophysiologic role in the development of AD‐HFpEF.https://www.ahajournals.org/doi/10.1161/JAHA.117.007385biomarkerdecompensated heart failurediastolic dysfunctiondiastolic heart failureejection fractionheart failure |
| spellingShingle | Abraham Abernethy Sadi Raza Jie‐Lena Sun Kevin J. Anstrom Russell Tracy Johannes Steiner Peter VanBuren Martin M. LeWinter Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomarker decompensated heart failure diastolic dysfunction diastolic heart failure ejection fraction heart failure |
| title | Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction |
| title_full | Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction |
| title_fullStr | Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction |
| title_full_unstemmed | Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction |
| title_short | Pro‐Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction |
| title_sort | pro inflammatory biomarkers in stable versus acutely decompensated heart failure with preserved ejection fraction |
| topic | biomarker decompensated heart failure diastolic dysfunction diastolic heart failure ejection fraction heart failure |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007385 |
| work_keys_str_mv | AT abrahamabernethy proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT sadiraza proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT jielenasun proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT kevinjanstrom proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT russelltracy proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT johannessteiner proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT petervanburen proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction AT martinmlewinter proinflammatorybiomarkersinstableversusacutelydecompensatedheartfailurewithpreservedejectionfraction |