Plasma Kynurenine Predicts Severity and Complications of Heart Failure and Associates with Established Biochemical and Clinical Markers of Disease

Autor: Karl-Heinz Kellner, Andreas Meinitzer, Robert Klüsener, Thomas Dschietzig, Felix Boschann, Katrin Sasse, Franz Paul Armbruster, Dragic Bankovic, Veselin Mitrovic, Christoph Melzer, Jana Ruppert
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
030232 urology & nephrology
Logistic regression
lcsh:RC870-923
Ventricular Function
Left
chemistry.chemical_compound
0302 clinical medicine
Natriuretic Peptide
Brain
lcsh:Dermatology
Kynurenine
Aged
80 and over
Immunoassay
Ejection fraction
Tryptophan
General Medicine
Middle Aged
Nephrology
Cohort
Cardiology
Biomarker (medicine)
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Renal function
Inflammation
Heart failure
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Humans
cardiovascular diseases
Mortality
Exercise
Aged
business.industry
Stroke Volume
Biomarker
lcsh:RL1-803
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
Peptide Fragments
chemistry
lcsh:RC666-701
Chronic Disease
business
Biomarkers
Zdroj: Kidney & Blood Pressure Research, Vol 44, Iss 4, Pp 765-776 (2019)
ISSN: 1423-0143
1420-4096
Popis: Background: Kynurenine, a metabolite of the L-tryptophan pathway, plays a pivotal role in neuro-inflammation, cancer immunology, and cardiovascular inflammation, and has been shown to predict cardiovascular events. Objectives: It was our objective to increase the body of data regarding the value of kynurenine as a biomarker in chronic heart failure (CHF). Methods: We investigated the predictive value of plasma kynurenine in a CHF cohort (CHF, n = 114); in a second cohort of defibrillator carriers with CHF (AICD, n = 156), we determined clinical and biochemical determinants of the marker which was measured by enzyme immunoassay. Results: In the CHF cohort, both kynurenine and NT-proBNP increased with NYHA class. Univariate binary logistic regression showed kynurenine to predict death within a 6-month follow-up (OR 1.43, 95% CI 1.03–2.00, p = 0.033) whereas NT-proBNP did not contribute significantly. Kynurenine, like NT-proBNP, was able to discriminate at a 30% threshold of left ventricular ejection fraction (LVEF; AUC-ROC, both 0.74). Kynurenine correlated inversely with LVEF (ϱ = –0.394), glomerular filtration fraction (GFR; ϱ = –0.615), and peak VO2 (ϱ = –0.626). Moreover, there was a strong correlation of kynurenine with NT-proBNP (ϱ = 0.615). In the AICD cohort, multiple linear regression analysis demonstrated highly significant associations of kynurenine with GFR, hsCRP, and tryptophan, as well as a significant impact of age. Conclusions: This work speaks in favor of kynurenine being a new and valuable biomarker of CHF, with particular attention placed on its ability to predict mortality and reflect exercise capacity.
Databáze: OpenAIRE
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