scholarly journals Inflammation-Related Biomarkers Are Associated with Heart Failure Severity and Poor Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1006
Author(s):  
Ieva Kažukauskienė ◽  
Vaida Baltrūnienė ◽  
Ieva Rinkūnaitė ◽  
Edvardas Žurauskas ◽  
Dalius Vitkus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Clinical Outcomes ◽  
Interleukin 6 ◽  
Cardiac Event ◽  
Tnf Α ◽  
Failure Severity ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
Hs Crp ◽  
Heart Failure Severity

Inflammation-related biomarkers are associated with clinical outcomes in mixed-etiology chronic heart failure populations. Inflammation-related markers tend to be higher in ischemic than in non-ischemic dilated cardiomyopathy (NI-DCM) patients, which might impact their prognostic performance in NI-DCM patients. Therefore, we aimed to assess the association of inflammation-related biomarkers with heart failure severity parameters and adverse cardiac events in a pure NI-DCM patient cohort. Fifty-seven patients with NI-DCM underwent endomyocardial biopsy. Biopsies were evaluated by immunohistochemistry for CD3+, CD45ro+, CD68+, CD4+, CD54+, and HLA-DR+ cells. Blood samples were tested for high-sensitivity C-reactive protein (hs-CRP), interleukin-6, tumor necrosis factor-α (TNF-α), soluble urokinase-type plasminogen activator receptor and adiponectin. During a five-year follow-up, twenty-seven patients experienced at least one composite adverse cardiac event: left ventricle assist device implantation, heart transplantation or death. Interleukin-6, TNF-α and adiponectin correlated with heart failure severity parameters. Patients with higher levels of interleukin-6, TNF-α, adiponectin or hs-CRP, or a higher number of CD3+ or CD45ro+ cells, had lower survival rates. Interleukin-6, adiponectin, and CD45ro+ cells were independently associated with poor clinical outcomes. All patients who had interleukin-6, TNF-α and adiponectin concentrations above the threshold experienced an adverse cardiac event. Therefore, a combination of these cytokines can identify high-risk NI-DCM patients.

Plasma osteopontin levels, but not its myocardial expression, reflect heart failure severity in recently diagnosed dilated cardiomyopathy

Herz ◽  
2019 ◽  
Vol 45 (S1) ◽  
pp. 105-110
Author(s):  
J. Podzimkova ◽  
T. Palecek ◽  
P. Kuchynka ◽  
J. Marek ◽  
B. A. Danek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Failure Severity ◽  
Heart Failure Severity

Albuminuria: Associated With Heart Failure Severity and Impaired Clinical Outcomes

2020 ◽  
Vol 36 (4) ◽  
pp. 527-534 ◽  
Author(s):  
Mony Shuvy ◽  
Donna R. Zwas ◽  
Chaim Lotan ◽  
Andre Keren ◽  
Israel Gotsman
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Failure Severity ◽  
Heart Failure Severity

Abstract 15684: Discordance Between Severity of Heart Failure as Determined by Patient Report versus Cardiopulmonary Exercise Testing

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Katherine C Michelis ◽  
Justin L Grodin ◽  
Lin Zhong ◽  
Ambarish Pandey ◽  
Kathleen Toto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Patient Reported Outcomes ◽  
Cardiopulmonary Exercise Testing ◽  
Risk Of Death ◽  
Increased Risk ◽  
Patient Reported ◽  
Failure Severity ◽  
Lower Severity ◽  
Heart Failure Severity

Introduction: Although patient-reported outcomes are increasingly emphasized, symptoms may be discordant to objective parameters of heart failure severity. The frequency of such discordance, associated characteristics, and its influence on clinical outcomes is unknown. Methods: This is a post-hoc analysis of the HF-ACTION trial (N=2062). Participants were divided by median baseline values for Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ, subjective measure) and V E /VCO 2 slope (objective measure) into 4 groups: “concordant-lower severity” (high KCCQ, low V E /VCO 2 slope), “concordant-higher severity” (low KCCQ, high V E /VCO 2 slope), “symptom magnifier” (low KCCQ, V E /VCO 2 slope), and “symptom minimizer” (high KCCQ, V E /VCO 2 slope). Baseline characteristics were compared, and the relationship between group and clinical outcomes over a median follow-up of 442 days was assessed in adjusted Cox models. Results: Discordance of patient-reported and objective illness severity was common (46%). Depression was more prevalent among symptom magnifiers (N=480) versus concordant-lower severity (N=566) and symptom minimizer (N=465) groups (30%, 18%, 14%, respectively; P<0.001). Compared to concordant-lower severity participants, those who were symptom magnifiers, symptom minimizers, or concordant-higher severity were at increased risk of hospitalization (Table). Concordant-higher severity participants and symptom minimizers, but not symptom magnifiers, were at an increased risk of death versus concordant-lower severity participants. Conclusion: A high rate of discordance was observed between patient-reported and objective heart failure severity. Depression was associated with symptom magnification. Hospitalization was influenced by patient-reported severity but mortality tracked more closely with objective data, highlighting potential limitations of static patient-reported outcomes for risk stratification.

scholarly journals Adrenergic receptor genotype influences heart failure severity and β-blocker response in children with dilated cardiomyopathy

2014 ◽  
Vol 77 (2) ◽  
pp. 363-369 ◽  
Author(s):  
Sushma Reddy ◽  
Alan Fung ◽  
Cedric Manlhiot ◽  
Elif Seda Selamet Tierney ◽  
Wendy K. Chung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Adrenergic Receptor ◽  
Failure Severity ◽  
Β Blocker ◽  
Heart Failure Severity

scholarly journals Intravenous iron therapy and circulating biomarkers of inflammation in men with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Drozd ◽  
M Tkaczyszyn ◽  
K Wegrzynowska-Teodorczyk ◽  
M Kasztura ◽  
M Dziegala ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intravenous Iron ◽  
Inflammatory Biomarkers ◽  
Iron Therapy ◽  
Reduced Ejection Fraction ◽  
Tnf Α ◽  
Inflammatory State ◽  
Iv Iron ◽  
Hs Crp ◽  
Intravenous Iron Therapy

Abstract Background Large randomized clinical trials have demonstrated that intravenous (IV) iron therapy in iron-deficient patients with heart failure with reduced ejection fraction (HFrEF) brings clinical benefits related to symptoms of the disease and exercise capacity. Mechanisms underlying beneficial effects of such repletion are still the subject of interest as this is not solely related to improved haematopoiesis (IV iron works also in non-anaemic subjects). In patients with chronic heart failure iron deficiency (ID) is linked with inflammatory processess but data regarding the impact of IV iron on inflammation is scarce. Purposes We evaluated whether IV iron therapy affects circulating biomarkers of pro-inflammatory state in men with HFrEF and concomitant ID. Methods This is the sub-analysis of the study to investigate the effects of IV ferric carboxymaltose (FCM) on the functioning of skeletal muscles in men with HFrEF. For the purposes of current research we analyzed data of 20 men with HFrEF (median age 68 (62, 75 – in brackets interquartile ranges, respectively) years, LVEF: 30 (25, 35) %, ischaemic HF aetiology: 85%, NYHA class I/II/III: 30%/50%/20%) and ID (definition according to ESC guidelines - ferritin &lt;100 ng/mL, or ferritin 100–299 ng/mL with transferrin saturation [TSAT] &lt;20%) who were randomized in a 1:1 ratio to receive either the 24-week therapy with IV FCM (dosing scheme as in the CONFIRM-HF trial) or saline (controls). The study was double-blinded. We used ELISA to evaluate different circulating pro-inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNF-α], interleukin 6 [IL-6], interleukin 1 beta [IL-1β], interleukin 22 [IL-22]) at baseline and week 24. Results IV FCM therapy repleted iron stores in men with HFrEF as reflected by an increase in serum ferritin and TSAT, which was not seen in a control group. IV FCM therapy (as well as the saline administration) affected neither haemoglobin concentration nor parameters reflecting iron stores in red cells. Baseline serum ferritin was not related to hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 (all p&gt;0.23). Baseline TSAT was related to hs-CRP (r=−0.47, p=0.02) but not other inflammatory biomarkers. Levels of hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 at week 0 were similar in subjects who received IV iron and controls (all p&gt;0.22). Change from week 0 to week 24 adjusted for baseline value (delta W24-W0 as the percentage of W0) regarding IL-22 was lower in an active treatment arm as compared with saline (p=0.049) and there was a trend towards lower delta TNF-α in FCM group compared to saline (p=0.067). These findings were not valid for other measured pro-inflammatory biomarkers. Conclusions In men with HFrEF and concomitant ID intravenous iron therapy with FCM affects biomarkers of pro-inflammatory state. Clinical relevance of this finding requires further translational research. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research was funded by the National Science Centre (Poland) grant allocated on the basis of the decision number DEC-2012/05/E/NZ5/00590

Long-term follow-up of cardiac resynchronization therapy patients with non-ischemic dilated cardiomyopathy assessed by radionuclide angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Valzania ◽  
R Bonfiglioli ◽  
F Fallani ◽  
J Frisoni ◽  
M Biffi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Radionuclide Angiography ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Long Term Follow Up ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
Lv Ejection Fraction

Abstract Background While the beneficial effects of cardiac resynchronization therapy (CRT) have been widely investigated soon after CRT implantation, relatively few data are available on long-term clinical outcomes of CRT recipients. Aim To investigate long-term outcomes of CRT patients with non-ischemic dilated cardiomyopathy stratified as responders and non-responders according to radionuclide angiography. Methods Consecutive heart failure patients with non-ischemic dilated cardiomyopathy undergoing CRT implantation at our University Hospital between 2007 and 2013 were enrolled. All patients were assessed with equilibrium Tc99 radionuclide angiography at baseline and after 3 months of CRT. Left ventricular (LV) ejection fraction was computed on the basis of relative end-diastolic and end-systolic counts, and intraventricular dyssynchrony was derived by Fourier phase analysis. Response to CRT was defined by an absolute increase in LV ejection fraction (LVEF) ≥5% at 3-month follow-up. Clinical outcome was assessed after 10 years through hospital records review. Results Forty-seven patients (83% men, 63±11 years) were included in the study. At 3 months, 25 (53%) patients were identified as CRT responders according to LVEF increase (from 26±8 to 38±12%, p&lt;0.001). In these patients, LV dyssynchrony decreased from 59±30° to 29±18° (p&lt;0.001). Twenty-two (47%) patients were defined as non-responders. No significant changes in LVEF and LV dyssynchrony (50±30° vs. 38±19°, p=0.07) were observed in non-responders. At long-term follow-up (11±2 years), all-cause and cardiac mortality rates were 24% and 12% in responders vs. 32% and 27% in non-responders, respectively (p=ns). Heart transplantation was performed in 3 patients. One (4%) patient among CRT responders compared with 6 (27%) patients among non-responders died of worsening heart failure (p=0.03). Conclusions Although late overall mortality of non-ischemic CRT recipients was not significantly different between mid-term responders and non-responders, CRT responders were at lower risk of worsening heart failure death. Funding Acknowledgement Type of funding source: None

Association of diet with clinical outcomes in dogs with dilated cardiomyopathy and congestive heart failure

2021 ◽  
Author(s):  
Ashley L. Walker ◽  
Teresa C. DeFrancesco ◽  
John D. Bonagura ◽  
Bruce W. Keene ◽  
Kathryn M. Meurs ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Clinical Outcomes
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