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Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction.

Publication ,  Journal Article
Abernethy, A; Raza, S; Sun, J-L; Anstrom, KJ; Tracy, R; Steiner, J; VanBuren, P; LeWinter, MM
Published in: J Am Heart Assoc
April 12, 2018

BACKGROUND: Underlying 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 RESULTS: Using 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). CONCLUSIONS: Levels 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.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

April 12, 2018

Volume

7

Issue

8

Location

England

Related Subject Headings

  • Stroke Volume
  • Serum Amyloid P-Component
  • Prospective Studies
  • Prognosis
  • Phosphodiesterase 5 Inhibitors
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Male
  • Inflammation
  • Humans
 

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Abernethy, A., Raza, S., Sun, J.-L., Anstrom, K. J., Tracy, R., Steiner, J., … LeWinter, M. M. (2018). Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc, 7(8). https://doi.org/10.1161/JAHA.117.007385
Abernethy, Abraham, Sadi Raza, Jie-Lena Sun, Kevin J. Anstrom, Russell Tracy, Johannes Steiner, Peter VanBuren, and Martin M. LeWinter. “Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction.J Am Heart Assoc 7, no. 8 (April 12, 2018). https://doi.org/10.1161/JAHA.117.007385.
Abernethy A, Raza S, Sun J-L, Anstrom KJ, Tracy R, Steiner J, et al. Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc. 2018 Apr 12;7(8).
Abernethy, Abraham, et al. “Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction.J Am Heart Assoc, vol. 7, no. 8, Apr. 2018. Pubmed, doi:10.1161/JAHA.117.007385.
Abernethy A, Raza S, Sun J-L, Anstrom KJ, Tracy R, Steiner J, VanBuren P, LeWinter MM. Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc. 2018 Apr 12;7(8).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

April 12, 2018

Volume

7

Issue

8

Location

England

Related Subject Headings

  • Stroke Volume
  • Serum Amyloid P-Component
  • Prospective Studies
  • Prognosis
  • Phosphodiesterase 5 Inhibitors
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Male
  • Inflammation
  • Humans