Christoph Sinning1, Tibor Kempf1, Michael Schwarzl2, Simon Lanfermann1, Francisco Ojeda1, Renate B Schnabel2, Elvin Zengin1, Philipp S Wild3, Karl-J Lackner4, Thomas Munzel5, Stefan Blankenberg2, Kai C Wollert6, Tanja Zeller2, Dirk Westermann7. 1. University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany. 2. University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany. 3. German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Germany; University Medical Center of the Johannes Gutenberg-University Mainz, Department of Medicine 2, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany. 4. Institute of Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. 5. German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Germany; University Medical Center of the Johannes Gutenberg-University Mainz, Department of Medicine 2, Mainz, Germany. 6. Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. 7. University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany. Electronic address: d.westermann@uke.de.
Abstract
BACKGROUND: Heart failure (HF) incidence is rising worldwide and HF with preserved ejection fraction (HFpEF) represents nearly half of all cases. Treatment options are still limited in HFpEF in comparison to HF with reduced ejection fraction (HFrEF). METHODS: We analyzed biomarkers in the general population to characterize HFpEF and HFrEF and defined a biomarker index to differentiate HFpEF from HFrEF. Growth differentiation factor-15 (GDF-15), soluble source of tumorigenicity 2 (sST2), C-reactive protein (CRP) and NT-proBNP were measured in 5000 individuals of the population-based Gutenberg Health Study (GHS). The median follow-up time for all-cause mortality was 7.3years with 213 events. RESULTS: Identification of subjects with HF was improved by GDF-15 (p<0.001) in addition to NT-proBNP with an odds ratio (OR) of 1.4 (95% confidence interval [CI]:1.1-1.7). Discrimination of subjects with and without HF was slightly higher for GDF-15 (area under the ROC curve [AUC]:0.79 [95%CI:0.75-0.83]) compared to NT-proBNP (AUC:0.77 [95% CI:0.72-0.82]). For subjects with HF, differentiating HFpEF from HFrEF was feasible with the index ((CRP+GDF-15+sST2)/NT-proBNP) with an OR of 3.7 (95% CI:1.9-8.5) (p<0.001). The best biomarkers predicting all-cause mortality were NT-proBNP and GDF-15 with a hazard ratio (HR) of 1.9 (95% CI:1.6-2.2) and 1.7 (95%CI:1.6-1.9) (both p<0.001), respectively. CONCLUSION: GDF-15 was useful to detect prevalent HF in addition to NT-proBNP and was elevated in HFrEF and HFpEF, whereas NT-proBNP was higher in HFrEF than in HFpEF. All biomarkers were useful to predict mortality in the general population. The index of ((CRP+GDF-15s+sST2)/NT-proBNP) was able to discriminate HFpEF from HFrEF.
BACKGROUND:Heart failure (HF) incidence is rising worldwide and HF with preserved ejection fraction (HFpEF) represents nearly half of all cases. Treatment options are still limited in HFpEF in comparison to HF with reduced ejection fraction (HFrEF). METHODS: We analyzed biomarkers in the general population to characterize HFpEF and HFrEF and defined a biomarker index to differentiate HFpEF from HFrEF. Growth differentiation factor-15 (GDF-15), soluble source of tumorigenicity 2 (sST2), C-reactive protein (CRP) and NT-proBNP were measured in 5000 individuals of the population-based Gutenberg Health Study (GHS). The median follow-up time for all-cause mortality was 7.3years with 213 events. RESULTS: Identification of subjects with HF was improved by GDF-15 (p<0.001) in addition to NT-proBNP with an odds ratio (OR) of 1.4 (95% confidence interval [CI]:1.1-1.7). Discrimination of subjects with and without HF was slightly higher for GDF-15 (area under the ROC curve [AUC]:0.79 [95%CI:0.75-0.83]) compared to NT-proBNP (AUC:0.77 [95% CI:0.72-0.82]). For subjects with HF, differentiating HFpEF from HFrEF was feasible with the index ((CRP+GDF-15+sST2)/NT-proBNP) with an OR of 3.7 (95% CI:1.9-8.5) (p<0.001). The best biomarkers predicting all-cause mortality were NT-proBNP and GDF-15 with a hazard ratio (HR) of 1.9 (95% CI:1.6-2.2) and 1.7 (95%CI:1.6-1.9) (both p<0.001), respectively. CONCLUSION:GDF-15 was useful to detect prevalent HF in addition to NT-proBNP and was elevated in HFrEF and HFpEF, whereas NT-proBNP was higher in HFrEF than in HFpEF. All biomarkers were useful to predict mortality in the general population. The index of ((CRP+GDF-15s+sST2)/NT-proBNP) was able to discriminate HFpEF from HFrEF.
Authors: Claire Tonry; Ken McDonald; Mark Ledwidge; Belinda Hernandez; Nadezhda Glezeva; Cathy Rooney; Brian Morrissey; Stephen R Pennington; John A Baugh; Chris J Watson Journal: ESC Heart Fail Date: 2021-03-28
Authors: Aleksandra Gombozhapova; Yuliya Rogovskaya; Vladimir Shurupov; Mariya Rebenkova; Julia Kzhyshkowska; Sergey V Popov; Rostislav S Karpov; Vyacheslav Ryabov Journal: J Biomed Sci Date: 2017-02-07 Impact factor: 8.410
Authors: Gary Tse; Christina Ip; King Sum Luk; Mengqi Gong; Yan Yee Ting; Ishan Lakhani; George Bazoukis; Guangping Li; Konstantinos P Letsas; Mei Dong; Tong Liu; Martin C S Wong Journal: Heart Asia Date: 2018-03-06