Vitamin K Status, Warfarin Use, and Arterial Stiffness in Heart Failure
| Autor: | Swetha Gaddam, Anique Mustafa, Scott Akers, Bilal Ansari, Julio A. Chirinos, Zeba Hashmath, Garrett Oldland, Izzah Vasim, Khuzaima Javaid, Jonathan Lee |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Vitamin medicine.medical_specialty Vitamin K 030232 urology & nephrology Pulse Wave Analysis 030204 cardiovascular system & hematology Article 03 medical and health sciences chemistry.chemical_compound Vascular Stiffness 0302 clinical medicine Internal medicine Matrix gla protein Internal Medicine Humans Medicine Prospective Studies Pulse wave velocity Aged Heart Failure Extracellular Matrix Proteins Ejection fraction biology business.industry Calcium-Binding Proteins Warfarin Stroke Volume Middle Aged medicine.disease Pathophysiology chemistry Heart failure biology.protein Arterial stiffness Cardiology Female business medicine.drug |
| Zdroj: | Hypertension. 73:364-370 |
| ISSN: | 1524-4563 0194-911X |
| Popis: | Large artery stiffening contributes to the pathophysiology of heart failure (HF) and associated comorbidities. MGP (matrix Gla-protein) is a potent inhibitor of vascular calcification. MGP activation is vitamin K–dependent. We aimed (1) to compare dp-ucMGP (dephospho-uncarboxylated MGP) levels between subjects with HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) and subjects without HF; (2) to assess the relationship between dp-ucMGP levels and arterial stiffness; and (3) to assess the relationship between warfarin use, dp-ucMGP levels, and arterial stiffness in HF. We enrolled 348 subjects with HFpEF (n=96), HFrEF (n=53), or no HF (n=199). Carotid-femoral pulse wave velocity, a measure of large artery stiffness, was measured with arterial tonometry. Dp-ucMGP was measured with ELISA. Dp-ucMGP levels were greater in both HFrEF (582 pmol/L; 95% CI, 444–721 pmol/L) and HFpEF (549 pmol/L; 95% CI, 455–643 pmol/L) compared with controls (426 pmol/L; 95% CI, 377–475 pmol/L; ANCOVA P =0.0067). Levels of dp-ucMGP were positively associated with carotid-femoral pulse wave velocity (standardized β, 0.31; 95% CI, 0.19–0.42; P P =0.0002). Warfarin use was significantly associated with carotid-femoral pulse wave velocity (standardized β, 0.13; 95% CI, 0.004–0.26; P =0.043), but this relationship was eliminated after adjustment for dp-ucMGP. In conclusion, levels of dp-ucMGP are increased in HFpEF and HFrEF and are independently associated with arterial stiffness. Future studies should investigate whether vitamin K supplementation represents a suitable therapeutic strategy to prevent or reduce arterial stiffness in HFpEF and HFrEF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|