Etienne Gayat1, Anaïs Caillard2, Saïd Laribi3, Christian Mueller4, Malha Sadoune5, Marie-France Seronde6, Alan Maisel7, Jozef Bartunek8, Marc Vanderheyden8, Johan Desutter9, Paul Dendale10, Gregoire Thomas11, Miguel Tavares12, Alain Cohen-Solal13, Jane-Lise Samuel14, Alexandre Mebazaa2. 1. Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France. Electronic address: etienne.gayat@lrb.aphp.fr. 2. Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France. 3. Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Emergency Department, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France. 4. University Hospital Basel, Basel, Switzerland. 5. UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France. 6. UMR-S 942, INSERM, Paris, France; Department of Cardiology EA3920, University Hospital Jean Minjoz, Besancon, France. 7. San Diego VA Medical Center, University of California, San Diego, CA, USA. 8. Cardiovascular Center, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium. 9. Department of Cardiology, AZ Maria Middelares Hospital Gent, University Gent, Belgium. 10. Hasselt University, Heart Centre Hasselt, Hasselt, Belgium. 11. SQU4RE, Lokeren, Belgium. 12. Hospital Geral de Santo Antonio, Porto, Portugal. 13. UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France; Department of Cardiology, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, France. 14. Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France.
Abstract
BACKGROUND: The present study involved both human cohorts and animal experiments to explore the performance of soluble CD146 (sCD146), a marker of endothelial function, as a diagnostic marker of acutely decompensated heart failure (ADHF), to determine the influence of patients' characteristics on that performance and to explore the potential application of CD146 in the pathophysiology of ADHF. METHODS AND RESULTS: NT-proBNP and sCD146 were measured in three hundred ninety-one patients admitted to the emergency department for acute dyspnea. ROC curve analysis demonstrated that AUCs for ADHF diagnosis in dyspneic patients were 0.86 (95% CI: 0.82-0.90) for sCD146 and 0.90 (95% CI: 0.86-0.92) for NT-proBNP. Subgroup analyses demonstrated that adding sCD146 to NT-proBNP improved the diagnostic performance for patients lying in the gray zone of NT-proBNP (p=0.02) and could be especially useful for ruling-out ADHF. An experimental model of ADHF in rats using thoracic aortic constriction suggests that CD146 is expressed in the intima of large arteries and associated with both left ventricular function and organ congestion. CONCLUSIONS: sCD146, a marker of endothelial function, seems to be as powerful as NT-proBNP is used to detect the cardiac origin of an acute dyspnea. The combination of sCD146 and NT-proBNP may have better performance than NT-proBNP used alone in particular for patients underlying in the "gray" zone and could therefore be an improved option for ruling-out ADHF. Both experimental and human data suggest that CD146 is related to systolic left ventricular function and to organ congestion.
BACKGROUND: The present study involved both human cohorts and animal experiments to explore the performance of soluble CD146 (sCD146), a marker of endothelial function, as a diagnostic marker of acutely decompensated heart failure (ADHF), to determine the influence of patients' characteristics on that performance and to explore the potential application of CD146 in the pathophysiology of ADHF. METHODS AND RESULTS: NT-proBNP and sCD146 were measured in three hundred ninety-one patients admitted to the emergency department for acute dyspnea. ROC curve analysis demonstrated that AUCs for ADHF diagnosis in dyspneic patients were 0.86 (95% CI: 0.82-0.90) for sCD146 and 0.90 (95% CI: 0.86-0.92) for NT-proBNP. Subgroup analyses demonstrated that adding sCD146 to NT-proBNP improved the diagnostic performance for patients lying in the gray zone of NT-proBNP (p=0.02) and could be especially useful for ruling-out ADHF. An experimental model of ADHF in rats using thoracic aortic constriction suggests that CD146 is expressed in the intima of large arteries and associated with both left ventricular function and organ congestion. CONCLUSIONS: sCD146, a marker of endothelial function, seems to be as powerful as NT-proBNP is used to detect the cardiac origin of an acute dyspnea. The combination of sCD146 and NT-proBNP may have better performance than NT-proBNP used alone in particular for patients underlying in the "gray" zone and could therefore be an improved option for ruling-out ADHF. Both experimental and human data suggest that CD146 is related to systolic left ventricular function and to organ congestion.
Authors: Veli-Pekka Harjola; Wilfried Mullens; Marek Banaszewski; Johann Bauersachs; Hans-Peter Brunner-La Rocca; Ovidiu Chioncel; Sean P Collins; Wolfram Doehner; Gerasimos S Filippatos; Andreas J Flammer; Valentin Fuhrmann; Mitja Lainscak; Johan Lassus; Matthieu Legrand; Josep Masip; Christian Mueller; Zoltán Papp; John Parissis; Elke Platz; Alain Rudiger; Frank Ruschitzka; Andreas Schäfer; Petar M Seferovic; Hadi Skouri; Mehmet Birhan Yilmaz; Alexandre Mebazaa Journal: Eur J Heart Fail Date: 2017-05-30 Impact factor: 15.534
Authors: Tahar Chouihed; Stéphane Manzo-Silberman; Nicolas Peschanski; Sandrine Charpentier; Meyer Elbaz; Dominique Savary; Eric Bonnefoy-Cudraz; Said Laribi; Patrick Henry; Nicolas Girerd; Faiez Zannad; Carlos El Khoury Journal: Scand J Trauma Resusc Emerg Med Date: 2016-09-17 Impact factor: 2.953