| Autor: |
Fröhling T; Department for Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, 48149 Münster, Germany., Semo D; Department for Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, 48149 Münster, Germany., Mirna M; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Hospital of Salzburg, 5020 Salzburg, Austria., Paar V; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Hospital of Salzburg, 5020 Salzburg, Austria., Shomanova Z; Department of Cardiothoracic Surgery, University Hospital of Münster, 48149 Münster, Germany.; Interdisciplinary Heart Failure Section, University Hospital Münster, 48149 Münster, Germany., Motloch LJ; Department of Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria.; Department of Internal Medicine II, Salzkammergut Klinikum, OÖG, 4840 Vöcklabruck, Austria.; Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, 4020 Linz, Austria., Rukosujew A; Department of Cardiothoracic Surgery, University Hospital of Münster, 48149 Münster, Germany., Sindermann JR; Department for Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, 48149 Münster, Germany.; Interdisciplinary Heart Failure Section, University Hospital Münster, 48149 Münster, Germany., Lichtenauer M; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Hospital of Salzburg, 5020 Salzburg, Austria., Pistulli R; Department for Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, 48149 Münster, Germany.; Interdisciplinary Heart Failure Section, University Hospital Münster, 48149 Münster, Germany. |
| Abstrakt: |
Background/Objectives: Heart failure (HF) remains a major therapeutic and diagnostic challenge nowadays. Albeit, acute decompensated HF is associated with several clinical signs such as dyspnea or edema, it remains a challenge to use easy accessible and suitable tools, such as biomarkers, to distinguish between patients at risk for an acute decompensation of their heart failure and compensated, stable HF patients. Existing biomarkers, such as natriuretic peptides or troponin, are not specific and can be elevated due to several other disease conditions, such as myocardial infarction, atrial fibrillation, or valve diseases. Therefore, the aim of this study was to analyze the predictive potential of four novel cardiovascular biomarkers-the soluble urokinase-type plasminogen activator receptor (suPAR), heart-type fatty acid binding protein (H-FABP), vascular cell adhesion molecule 1 (VCAM-1), and growth/differentiation factor 15 (GDF-15) for the detection of cardiac decompensation in patients with HF. Methods : In this study, 146 patients were prospectively enrolled and the serum biomarker concentrations were analyzed using Enzyme Linked Immunosorbent Assay (ELISA). We correlated the biomarker concentrations with clinical and biochemical parameters of all patients and the predictive value for detection of cardiac decompensation was assessed. Results: A significant increase in the levels of suPAR (1.6-fold-change, p < 0.0001), H-FABP (2.2-fold-change, p = 0.0458), VCAM-1 (1.6-fold-change, p < 0.0001), and GDF-15 (1.7-fold-change, p = 0.0009) was detected in all patients with acute decompensated HF in comparison to patients with compensated HF. Univariate logistic regression analysis revealed a significant association of biomarker plasma concentration with the risk for a cardiac decompensation (suPAR: p < 0.0001; VCAM-1: p < 0.0001, H-FABP: p = 0.0458; GDF-15: p = 0.0009). Conclusion s: In conclusion, the investigated novel cardiovascular biomarkers suPAR, GDF-15, VCAM-1, and H-FABP could be a valuable tool to facilitate therapeutic decisions in patients with heart failure and suspicion of a cardiac decompensation. Parameters such as renal function should be taken into account. Further studies on novel biomarkers are required to find reliable, sensitive, and specific tools that will enable the early detection of patients with acute decompensation. |
