Gene expression and levels of IL-6 and TNFα in PBMCs correlate with severity and functional class in patients with chronic heart failure

AbstractExacerbations of chronic heart failure (HF) with the necessity for hospitalisation impact hospital resources significantly. Despite all of the achievements in medical management and non-pharmacological therapy that improve the outcome in HF, new strategies are needed to prevent HF-related hospitalisations by keeping stable HF patients out of the hospital and focusing resources on unstable HF patients. Remote monitoring of these patients could provide the physicians with an additional tool to intervene adequately and promptly. Results of telemonitoring to date are inconsistent, especially those of telemonitoring with traditional non-haemodynamic parameters. Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. This review provides an overview of the available evidence on remote monitoring in chronic HF patients and future perspectives for the efficacy and cost-effectiveness of these strategies.

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Development of a diagnostic model focusing on nutritional indicators for frailty classification in people with chronic heart failure

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab080 ◽

2021 ◽

Author(s):

Yiqin Gu ◽

Chaofeng Li ◽

Jing Yan ◽

Guoping Yin ◽

Guilan Lu ◽

...

Keyword(s):

Heart Failure ◽

Folic Acid ◽

Chronic Heart Failure ◽

Nutritional Status ◽

Functional Class ◽

Brier Score ◽

Diagnostic Model ◽

Serum Samples ◽

Frailty Status ◽

C Statistic

Abstract Aims Frailty has a great impact on the quality of life of patients with chronic heart failure (CHF), which needs to be judged in time. To develop a diagnostic model based on nutritional indicators to judge the frailty status of patients with chronic heart failure (Frailty-CHF). Methods and results In the data collection part of this study, questionnaire method and biomedical measurement method were adopted. The trace elements in serum samples were detected by high performance liquid chromatography, chemiluminescence, and inductively coupled plasma mass spectrometry. We used Excel for data consolidation, and then imported the data into R software for modelling. Lasso method was used for variable screening, and Logistics regression fitting model was used after variables were determined. The internal validation of the model was completed by Bootstrap re-sampling. A total of 123 patients were included in this study. After variables’ screening, age, nutritional status-heart failure, New York Heart Association Functional Class (NYHA), micronutrients B12, Ca, folic acid, and Se were included in the model, the c statistic and Brier score of the original model were 0.9697 and 0.0685, respectively. After Bootstrap re-sampling adjustment, the c statistic and Brier score were 0.8503 and 0.1690. Conclusion In this study, a diagnostic model of age, nutritional status-heart failure, NYHA, the micronutrients B12, Ca, folic acid, and Se was established. It could help healthcare professionals better identify the frailty status in patients with CHF.

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The mechanism of adaptation of the organism of patients with chronic heart failure combined with vitamin D deficiency and the morphofunctional state of peripheral blood erythrocytes

Regulatory Mechanisms in Biosystems ◽

10.15421/021954 ◽

2019 ◽

Vol 10 (3) ◽

pp. 352-357

Author(s):

N. I. Baryla ◽

I. P. Vakaliuk ◽

S. L. Pоpеl’

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Chronic Heart Failure ◽

Red Blood Cells ◽

Vitamin D Deficiency ◽

Peripheral Blood ◽

Blood Cells ◽

Functional Class ◽

Exercise Stress ◽

Control Group

The problem of structural changes in peripheral blood erythrocytes in patients with chronic heart failure in combination with vitamin D deficiency during exercise stress remains insufficiently studied. Vitamin receptors are located on smooth myocytes, endothelial cells, cardiomyocytes and blood cells. It affects the state of the cell membrane, the contractile function of the myocardium, the regulation of blood pressure, cardiac remodeling and reduction of left ventricular hypertrophy. Therefore, it is important to assess the level of vitamin D in blood plasma in individuals with chronic heart failure and to identify the effect of its deficiency on the state of peripheral red blood cells when performing a 6-minute walk test. A total of 75 patients of the main group with chronic heart failure stage II A, I–II functional class with different levels of vitamin D deficiency were examined. The control group included 25 patients with chronic heart failure stage II A, functional class I–II without signs of vitamin D deficiency. The average age of patients was 57.5 ± 7.5 years. All patients were asked to undergo the 6 minutes walking test. The level of total vitamin D in plasma was determined by enzyme immunoassay. Morphological studies of erythrocytes were performed on the light-optical and electron-microscopic level. The obtained results showed that patients of the main group with chronic heart failure had a decrease in vitamin D by 2.2 times compared with the control group. Correlation analysis showed a directly proportional relationship between vitamin D deficiency and the number of red blood cells of a modified form and red blood cells with low osmotic resistance. Dosed exercise stress in patients with chronic heart failure against a background of vitamin D deficiency leads to an increase in the number of reversibly and irreversibly deformed erythrocytes and a decrease in their osmotic stability. This indicates a disorder in the structural integrity of their membrane and can have negative consequences for the somatic health of such patients.

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The relationship between myocardial gene expression of inducible nitric oxide synthase (NOS2) and the degree of myocardial inflammation and dysfunction in patients with chronic heart failure

Journal of Cardiac Failure ◽

10.1016/s1071-9164(03)00463-9 ◽

2003 ◽

Vol 9 (5) ◽

pp. S34

Author(s):

Wai Hong W. Tang ◽

Fernando Lopez ◽

Yin-Gail Yee ◽

Annie Mullin ◽

Ying Zhang ◽

...

Keyword(s):

Gene Expression ◽

Nitric Oxide ◽

Heart Failure ◽

Chronic Heart Failure ◽

Inducible Nitric Oxide Synthase ◽

Myocardial Inflammation ◽

Oxide Synthase ◽

Myocardial Gene Expression ◽

The Relationship ◽

Inducible Nitric Oxide

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Gene expression profiles in peripheral blood mononuclear cells of chronic heart failure patients

Physiological Genomics ◽

10.1152/physiolgenomics.90364.2008 ◽

2009 ◽

Vol 38 (3) ◽

pp. 233-240 ◽

Cited By ~ 37

Author(s):

Claudia Cappuzzello ◽

Monica Napolitano ◽

Diego Arcelli ◽

Guido Melillo ◽

Roberta Melchionna ◽

...

Keyword(s):

Gene Expression ◽

Heart Failure ◽

Chronic Heart Failure ◽

Chemokine Receptor ◽

Expression Profiling ◽

Mononuclear Cells ◽

Molecular Signature ◽

Peripheral Blood Mononuclear ◽

Control Subjects ◽

Blood Mononuclear Cells

The present study was aimed at identifying chronic heart failure (CHF) biomarkers from peripheral blood mononuclear cells (PBMCs) in patients with ischemic (ICM) and nonischemic dilated (NIDCM) cardiomyopathy. PBMC gene expression profiling was performed by Affymetrix in two patient groups, 1) ICM ( n = 12) and 2) NIDCM ( n = 12) New York Heart Association (NYHA) III/IV CHF patients, vs. 3) age- and sex-matched control subjects ( n = 12). Extracted RNAs were then pooled and hybridized to a total of 11 microarrays. Gene ontology (GO) analysis separated gene profiling into functional classes. Prediction analysis of microarrays (PAM) and significance analysis of microarrays (SAM) were utilized in order to identify a molecular signature. Candidate markers were validated by quantitative real-time polymerase chain reaction. We identified a gene expression profiling that distinguished between CHF patients and control subjects. Interestingly, among the set of genes constituting the signature, chemokine receptor (CCR2, CX3CR1) and early growth response (EGR1, 2, 3) family members were found to be upregulated in CHF patients vs. control subjects and to be part of a gene network. Such findings were strengthened by the analysis of an additional 26 CHF patients ( n = 14 ICM and n = 12 NIDCM), which yielded similar results. The present study represents the first large-scale gene expression analysis of CHF patient PBMCs that identified a molecular signature of CHF and putative biomarkers of CHF, i.e., chemokine receptor and EGR family members. Furthermore, EGR1 expression levels can discriminate between ICM and NIDCM CHF patients.

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Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure

Clinical Chemistry ◽

10.1373/clinchem.2003.021311 ◽

2003 ◽

Vol 49 (12) ◽

pp. 2020-2026 ◽

Cited By ~ 66

Author(s):

Junnichi Ishii ◽

Wei Cui ◽

Fumihiko Kitagawa ◽

Takahiro Kuno ◽

Yuu Nakamura ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Cardiac Troponin ◽

Troponin T ◽

Myocardial Damage ◽

Left Ventricular ◽

Functional Class ◽

Cardiac Troponin T ◽

Cardiac Events ◽

Nyha Functional Class

Abstract Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (>0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P <0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P <0.001). cTnT >0.01 μg/L and/or BNP >160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.

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Functional activity of platelets in aged patients with chronic heart failure with hyperbaric oxygenation

10.34014/mpphe.2021-6-8 ◽

2021 ◽

Author(s):

E.N. Altynbaeva ◽

V.I. Ruzov ◽

M.N. Goryachaya ◽

N.A. Slobodnjuk

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Functional Activity ◽

Hyperbaric Oxygenation ◽

Functional Class ◽

Hyperbaric Oxygen Treatment ◽

Initial State ◽

Aged Patients ◽

Oxygen Treatment ◽

Induced Aggregation

105 patients with chronic heart failure (CHF) with ischemic etiology of functional class were examined, among them 70 men (67%) and 35 women (33%), average age 78,67±13,80 years. A five-day course of hyperbaric oxygen treatment in the BLKS-303MK pressure chamber (Russia) in the 1.2 ATA with a 30-45 minutes session was accompanied by a study of the func-tional activity of platelets. It was found that after hyperbaric oxygenation treatment ADP-induced aggregation significantly decreased in women, spontaneous aggregation in men. How-ever, the nature of the response of platelet functional activity to hyperbaric oxygenation is af-fected by the initial state of the platelet hemostasis. Key words: platelets, hyperbaric oxygenation, platelet aggregation, heart failure, hemo-stasis.

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Energy Metabolism and Nutritional Status in Hospitalized Patients with Chronic Heart Failure

Annals of Nutrition and Metabolism ◽

10.1159/000507355 ◽

2020 ◽

Vol 76 (2) ◽

pp. 129-139

Author(s):

Shoko Yasuhara ◽

Mika Maekawa ◽

Shigeki Bamba ◽

Mika Kurihara ◽

Naoko Nakanishi ◽

...

Keyword(s):

Heart Failure ◽

Energy Metabolism ◽

Chronic Heart Failure ◽

Nutritional Status ◽

Inflammatory Cytokines ◽

Body Fat ◽

Functional Class ◽

Body Fat Percentage ◽

Fat Percentage ◽

Patients With Heart Failure

Introduction: Malnutrition is a factor that defines vital prognosis in chronic heart failure. Objective: This study investigated nutritional and metabolic disorders in patients with heart failure by examining the association of severity of heart failure with inflammatory cytokines, appetite-regulating hormones, and energy metabolism. Methods: Subjects were 50 patients with heart failure. On admission, nutritional status was assessed, and biochemical blood tests were performed, including for serum tumor necrosis factor-α, interleukin-6, ghrelin, and leptin levels. Resting energy expenditure (REE) was also measured by indirect calorimetry to examine its association with severity of heart failure and levels of inflammatory cytokines and appetite-regulating hormones. Results: There were significant associations between serum brain natriuretic peptide (BNP) level and nutrition indices, indicating that nutritional status was worse when heart failure was more severe. Inflammatory cytokine levels showed significant positive correlations with BNP level. Measured REE/bodyweight was not associated with severity of heart failure, but was negatively correlated with body fat percentage and leptin levels. Conclusions: Energy metabolism was not associated with serum BNP level among patients with heart failure with New York Heart Association functional class up to III. Body fat percentage and leptin levels may be a good predictor of energy metabolism in patients with heart failure.

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