scholarly journals CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE

2018 ◽  
Vol 8 (5) ◽  
pp. 333-345
Author(s):  
A. M. Aliyeva ◽  
E. V. Reznik ◽  
E. T. Hasanova ◽  
I. V. Zhbanov ◽  
I. G. Nikitin

Biomarkers (various laboratory biochemical markers), such as natriuretic peptides (NP), soluble ST2 receptor, copeptin, galectin-3, are widely studied in patients with chronic heart failure (CHF). The European Society of Cardiology recommends the determination of blood NP level in suspicion of HF and its use as one of the mandatory diagnostic criteria for CHF with preserved and mid-range ejection fraction. Dynamics of NP concentration may be predictor of the effectiveness of the therapy and the necessity of the titration of the dose of HF drugs. Neprilyzin destroys NP, but does not destroy their precursors, including NT-proBNP. Therefore, it is necessary to use NT-proBNP as a marker of therapeutic efficacy and prognosis when using neprilysine inhibitors (sacubitril). ST2 is a protein receptor for interleukin-33 (IL-33). The transmembrane ST2 (ST2L) binds to IL-33 and forms the IL-33/ST2L complex, which has a cardioprotective effect, prevents the development of myocardial hypertrophy, fibrosis and apoptosis. The soluble ST2 receptor (sST2) is a “trap” for IL-33 and neutralizes the protective effects of the IL-33/ST2L complex, which leads to hypertrophy and fibrosis of the myocardium, dilatation of the chambers and reduction of the contractility of the heart. It can be considered as a marker of unfavorable prognosis in heart failure, but it is not specific. Copeptin is a part of the arginine-vasopressin, or antidiuretic hormone, precursor which plays an important role in the pathogenesis of CHF. Since arginine-vasopressin has a short half-life and is unstable outside the body, copeptin is being actively investigated. Its level increases during the CHF decompensation and relates with the functional class of CHF. A combined measurement of the concentration of copeptin and NP may improve the risk stratification in CHF patients. Galectin-3 is a peptide that stimulates the activation of fibroblasts and the development of fibrosis. It increases in CHF patients and is associated with the severity of the condition, systolic and diastolic LV dysfunction and prognosis. Currently, NP are the best biomarkers that can and should be used in routine clinical practice. To prove the need for widespread use of other biomarkers, additional research is needed.

2017 ◽  
Vol 8 (4) ◽  
pp. 5-10
Author(s):  
K. A Giamdzhian ◽  
V. G Kukes

Relevance. At present, it is urgent to develop new biomarkers that can serve as a tool for early diagnosis of the disease in order to select pharmacotherapy and further monitor its effectiveness. The goal is to evaluate the clinical value of the definition of galectin-3 in patients with chronic heart failure (CHF). Materials and methods. The study included 53 patients (31 women, 22 men) with CHF II-III functional class (FC) of the New York Heart Association (NYHA). The mean age of the patients was 71 years (95% confidence interval 68.99-74.37). A group of patients with NYHA FCh II CHF made up 14 people, a group of patients with NYHA-39 CHF III FC. The median of the initial level of the N-terminal brain natriuretic peptide (NT-proBNP) was 65.7 pmol/L, the median of the initial level of galectin-3 - 8.37 pmol/l. Results. The relationship of increased level of galectin-3 with reduced ejection fraction,% (r=-0.26, p=0.04), increased creatinine level (r=0.26, p=0.04) and increased level of NT-proBNP plasma (r=0.3, p=0.02). With other clinical indicators, such as systolic and diastolic blood pressure, heart rate, body mass index, 6-minute walk test, left ventricular mass index, glucose level, total cholesterol, glomerular filtration rate, no statistically significant association was found. A moderate correlation was obtained between the levels of NT-proBNP and galectin-3 plasma (r=0.3, p=0.02). Reduction in the level of galectin-3 after the treatment was detected in 84.3% of patients. The conclusion. Galectin-3 can serve as an additional diagnostic biomarker of CHF.


2017 ◽  
pp. 63-68 ◽  
Author(s):  
K. A. Gyamdzhyan ◽  
V. G. Kukes ◽  
M. L. Maksimov

Relevance: today, the task of finding new biomarkers that could help monitor the effectiveness of pharmacotherapy, ensuring early diagnosis and predicting the clinical outcome of the disease continues to be relevant.Purpose: the purpose of the study was to assess the clinical value of determining galectin-3 in patients with chronic heart failure (CHF).Material and methods: the study included 53 patients (women n = 31, men n = 22) with CHF II-III FC NYHA. The mean age of patients was 71 (95% CI 68.99-74.37). The group of patients with CHF II NYHA included 14 people, and the group with CHF III NYHA - 39. The median baseline level for NT-proBNP was 65.7 pmol/L, the median baseline for galectin-3 - 8.37 pmol/L.Results: increased levels of galectin-3 correlated with reduced EF (%) (R = -0.26, p = 0.04), increased serum creatinine (r = 0.26, p = 0.04) and elevated plasma levels of NT-proBNP (r = 0.3, p = 0.02). No statistically significant relationship was obtained with other clinical indicators, such as SBP, DBP, heart rate, BMI, the 6-minute test, LVMI, LVM, glucose, TC, GFR. We obtained a moderate correlation between the plasma levels of NT-proBNP and galectin-3 (r = 0.3, p = 0.02). Reduced levels of galectin-3 after treatment were observed in 84.3% of patients.Conclusion. Galectin-3 can be used as an additional diagnostic biomarker for CHF. The incidence of congestive heart failure (CHF) is 1–2% among the population in the developed countries reaching >10% in patients aged over 70 years. [1] Despite a significant progress in the treatment of CHF over the past decades, the mortality rate is very high reaching 60% in men and 45% in women after 5 years after the initial diagnosis. [2] Therefore, the development of new methods for the prevention and treatment of CHF is a relevant medical and social problem. 


2018 ◽  
pp. 30-35
Author(s):  
V. O. Ruzhanska ◽  
V. G. Sivak ◽  
T. V. Polishchuk ◽  
V. M. Zhebel

The development of new methods for the prevention and treatment of chronic heart failure and its control is an urgent medical and social problem. In this regard, using of new biological markers of the disease may be useful for early diagnosis of the disease, predict a clinical course, monitor the effects of pharmacotherapy (personalized medicine) and play an important role in stratifying the patient's risk. In 2013, according to the recommendation of the American Heart Association, a galectin-3 was introduced into the pool of such biomarkers for prevention and treatment of chronic heart failure. Objective: to improve prediction of the course and effectiveness of the therapy for hypertension and chronic heart failure as the hypertension complication in men 40-60 years old by applying the level of galectin-3 as a biomarker. There were observed the men 40-60 years old with hypertension and chronic heart failure for the concentration of galectin-3. Also, there were observed subjects without cardiovascular pathology (n=79), the men with hypertonic disease with myocardial hypertension (n=62) and the men with chronic heart failure II-III functional class of NYHA (n=50) for the indicators of central and systemic hemodynamics. The level of galectin-3 was determined by immunoassay analysis on the equipment "Stat Fact 300". Structural and functional parameters of myocardium were assessed by an ultrasound method using the equipment "RADMIR ULTIMARA". Data statistical analysis was performed on a personal computer using standard statistical package "Statistica 10.0". All data is presented in the form of average (M) and standard deviation (± σ). It has been established that the concentration of galectin-3 significantly decreases against the background of treatment. The level of galectin-3 in the patients with the II stage of hypertonic disease with good treatment effect was close to normal values compared to those with moderate treatment effect. In terms of patients with hypertension III stage, the level of galectin-3 also decreased, indicating the possibility of therapy monitoring using this biomarker. The mathematical model of the galectin-3 influencing factors also has been determined in patients with hypertension. The boundary level of the galectin-3 has been calculated, it is counted 46.51 pg/ml. It might be assumed a moderate effect of the treatment of hypertensive patients and chronic heart failure in males.


2007 ◽  
Vol 6 (1) ◽  
pp. 29-29
Author(s):  
R FERNANDES ◽  
R SOARES ◽  
J FELICIANO ◽  
J SERRA ◽  
A MAMEDE ◽  
...  

2005 ◽  
Vol 46 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Pierre V Ennezat ◽  
Caroline A Ennezat ◽  
Pugazhendhi Vijayaraman ◽  
Justine Lachmann ◽  
Philippe Asseman ◽  
...  

2019 ◽  
Vol 28 (1) ◽  
pp. 3-13 ◽  
Author(s):  
J. F. Veenis ◽  
J. J. Brugts

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.


Sign in / Sign up

Export Citation Format

Share Document