Prognostic value of soluble biomarkers of haemodynamic stress, inflammation and fibrosis in hfpef: a retrospective cohort study

Filatova AYu, Sobolevskaya MS, Potekhina AV, et al. . Prognostic value of soluble biomarkers of haemodynamic stress, inflammation and fibrosis in hfpef: a retrospective cohort study. Russian Cardiology Bulletin. 2024;19(2):47‑54. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20241902147

Подписка 2025 (Russian Cardiology Bulletin)

Использование инфографики авторами научных работ

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OBJECTIVE

To evaluate prognostic role of inflammatory and fibrosis biomarkers in patients with heart failure and preserved ejection fraction (HFpEF).

MATERIAL AND METHODS

A retrospective cohort study included 348 outpatients with HFpEF who underwent clinical and instrumental evaluation between 2013 and 2020. The follow-up period was at least 3 years (median 5.4 years). The diagnosis of HFpEF was based on symptoms and signs of heart failure (HF), LV ejection fraction ≥50% and increased LV filling pressure. The primary endpoint was all-cause mortality and hospitalization due to exacerbation of HF. At baseline, we estimated serum (NT-proBNP), biomarkers of inflammation (highly sensitive C-reactive protein [hsCRP]) and fibrosis (growth differentiation factor-15 [GDF-15] and soluble interleukin 1 receptor-like 1 [sST2]). Survival rates were estimated using the Kaplan-Meier multiplier estimation method.

RESULTS. P

Rimary complication occurred in 48% of patients. NT-proBNP (relative risk [RR] 1.44, 95% CI 1.05 to 1.96, p=0.002) and GDF-15 (RR 1.68, 95% CI 1.02 to 2.77, p=0.043) were significantly associated with poor prognosis. Significance of hsCRP was unclear (p=0.07). Prognostic significance of NT-proBNP was superior to routine echocardiographic parameters characterizing diastolic dysfunction/LV filling pressure: left atrial volume index, pulmonary artery systolic pressure (PASP), ratio of early diastolic filling velocity to early diastolic LV base elevation velocity (E/e’) and LV mass index. Prognostic significance of GDF-15 was superior to PASP, E/e’ ratio and LV mass index.

CONCLUSION

Prognostic significance of GDF-15 and high prognostic role of myocardial stress marker NT-proBNP were confirmed in a large national ambulatory cohort of patients with HFpEF. Both biomarkers were superior to many routine echocardiographic parameters.

Keywords:

HFpEF

NT-proBNP

GDF-15

chronic inflammation

myocardial fibrosis

diastolic dysfunction

echocardiography

Authors:

Filatova A.Yu.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0001-8911-1628

Sobolevskaya M.S.

Chazov National Medical Research Center for Cardiology

ORCID: 0009-0006-7641-5191

Potekhina A.V.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0001-9290-9884

Svirida O.N.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0003-1317-036X

Masenko V.P.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0003-3280-3521

Kuznetsova T.V.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0001-5403-3885

Sharf T.V.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0003-1993-9264

Ageev F.T.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0003-3285-6148

Ovchinnikov A.G.

Chazov National Medical Research Center of Cardiology;
Evdokimov Moscow State University of Medicine and Dentistry

ORCID: 0000-0003-3285-6148

Received:

25.03.2024

Accepted:

26.03.2024

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