Biomarker-based phenotyping of myocardial fibrosis identifies patients with heart failure with preserved ejection fraction resistant to the beneficial effects of spironolactone: results from the Aldo-DHF trial

Autor:	Begoña López, Javier Díez, Susana Ravassa, Gerd Hasenfuss, Tobias Daniel Trippel, Anna F. Dominiczak, Rolf Wachter, Diana Bachran, Frank T. Edelmann, Arantxa González, Doris Bach, Burkert Pieske, Christian Delles
Rok vydání:	2018
Předmět:	0301 basic medicine medicine.medical_specialty business.industry 030204 cardiovascular system & hematology Placebo medicine.disease 03 medical and health sciences chemistry.chemical_compound 030104 developmental biology 0302 clinical medicine N-terminal telopeptide chemistry Internal medicine Heart failure Spironolactone Cardiology Medicine Biomarker (medicine) Myocardial fibrosis Cardiology and Cardiovascular Medicine Heart failure with preserved ejection fraction business Beneficial effects
Zdroj:	European Journal of Heart Failure. 20:1290-1299
ISSN:	1388-9842
Popis:	Background: Myocardial fibrosis is characterized by excessive cross‐linking and deposition of collagen type I and is involved in left ventricular stiffening and left ventricular diastolic dysfunction (LVDD). We investigated whether the effect of spironolactone on LVDD in patients with heart failure with preserved ejection fraction (HFpEF) depends on its effects on collagen cross‐linking and/or deposition. Methods and results: We investigated 381 HFpEF patients from the multicentre, randomized, placebo‐controlled Aldo‐DHF trial with measures of the E:e' ratio. The ratio of serum carboxy‐terminal telopeptide of collagen type I to serum matrix metalloproteinase‐1 (CITP:MMP‐1, an inverse index of myocardial collagen cross‐linking) and serum carboxy‐terminal propeptide of procollagen type I (PICP, a direct index of myocardial collagen deposition) were determined at baseline and after 1‐year treatment with spironolactone 25 mg once daily or placebo. Patients were classified by CITP:MMP‐1 and PICP tertiles at baseline. While CITP:MMP‐1 tertiles at baseline interacted (P
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::3850e72a89e2e3919c8808218fa41f5b https://doi.org/10.1002/ejhf.1194 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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