scholarly journals Higher Serum Phosphorus Is Not an Independent Risk Factor of Mortality in Heart Failure with Reduced Ejection Fraction

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4004
Author(s):  
Partyka Robert ◽  
Mroczek Alina ◽  
Duda Sylwia ◽  
Malinowska-Borowska Jolanta ◽  
Buczkowska Marta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elevated Serum ◽  
Serum Levels ◽  
Normal Serum ◽  
Serum Phosphorus ◽  
Prognostic Information ◽  
Reduced Ejection Fraction ◽  
Risk Of Mortality ◽  
Relationship Of ◽  
The Relationship

Higher serum phosphorus has detrimental health effects. Even high-normal rage sP is associated with worse outcomes. The relationship of serum phosphorus with prognostic markers in heart failure remains unclear. We investigated the association of serum phosphorus with heart failure prognostic factors and risk of mortality related to serum phosphorus. In 1029 stable heart failure patients, we investigated the distribution of markers of more advanced heart failure stage across quintiles of serum phosphorus and estimated the relative risk of mortality in comparison to reference. Higher serum phosphorus levels sP were associated with markers of a worse outcome. The best survival was observed in low-normal serum levels. The unadjusted hazard ratio for mortality increased toward higher phosphorus quintiles but not to lower levels of sP. The correction for age, sex, BMI, percent weight loss, inflammation, kidney function, and LVEF did not modify the risk profile substantially. The adjustment for NYHA, natriuretic peptides, serum sodium, and treatment characteristics broke down the risk relationship completely. A higher serum phosphorus is associated with markers of a more risky profile of heart failure. Elevated serum levels of phosphorus sP does not provide independent prognostic information beyond the strongest markers of the severity of the syndrome. The potential involvement of higher serum phosphorus as a mediator in the pathophysiology of heart failure warrants further study.

scholarly journals The relationship between systolic function and serum NGAL levels in patients with chronic heart failure of ischemic origin

2021 ◽  
Vol 23 (2) ◽  
pp. 184-188
Author(s):  
V. A. Lysenko ◽  
V. V. Syvolap ◽  
M. S. Potapenko
Keyword(s):  
Heart Failure ◽  
Heart Function ◽  
Systolic Function ◽  
Elevated Serum ◽  
Left Ventricular Systolic Function ◽  
Serum Levels ◽  
Left Ventricular ◽  
Normal Serum ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
The Relationship

Neutrophil gelatinase-associated lipocalin (NGAL) is considered one of the most informative biomarkers of chronic kidney disease (CKD). NGAL can also serve as a biomarker of cardiovascular disease and heart failure (HF). However, the relationship between systolic function and serum NGAL concentrations in patients with chronic HF (CHF) of ischemic origin remains insufficiently studied. The aim. To study the influence of tubulo-interstitial injury marker NGAL on systolic function in patients with CHF of ischemic origin. Materials and methods. The study included 51 patients with CHF, stage II AB, NYHA II-IV FC. Doppler echocardiographic examination was performed on the device Esaote MyLab Eight (Italy) according to standard methods. NGAL levels were analyzed using an ELISA kit (E-EL-H0096, Elabscience, USA). Depending to the concentration of serum NGAL, the patients were divided into 2 subgroups. In the first group (n = 37), the NGAL level was higher than 168 ng/ml, in the second (n = 14) – less than 168 ng/ml. Results. The mean serum NGAL concentration in the first subgroup was 192 (183; 200) ng/ml, in the second subgroup – 154 (134; 160) ng/ml. The patients with CHF of ischemic origin with tubulo-interstitial injury (according to the serum concentration of NGAL) did not differ significantly from the patients with CHF of ischemic origin without tubulo-interstitial injury in age (P = 0.950), height (P = 0.983), weight (P = 0.681), body surface area (P = 0.975). Most of left ventricular systolic function indicators showed a downward tendency (S 6.90 ± 2.85 cm/s vs. 7.67 ± 2.83 cm/s (P = 0.536); S lat 7.33 ± 2.08 cm/s vs. 11.00 ± 4.00 cm/s (P = 0.467); TEI LV 0.56 ± 0.26 c.u. vs. 0.49 ± 0.14 c.u. (P = 0.747)) in the patients with CHF of ischemic origin with elevated serum levels of NGAL compared to similar indicators in the patients with CHF of ischemic origin without tubulo-interstitial injury. The index of LVEF was significantly lower in the patients with CHF with elevated serum NGAL compared to that in the patients with CHF with normal serum NGAL (50.43 ± 17.85 % vs. 63.29 ± 13.24 % (P = 0.021)). Conclusions. Serum NGAL was not only the sensitive marker of tubulo-interstitial injury in patients with CHF of ischemic origin, but also appeared to be a predictor of changes in systolic heart function.

scholarly journals Clinical and laboratory observations on serum folate-binding protein

Blood ◽  
1975 ◽  
Vol 46 (4) ◽  
pp. 599-609 ◽  
Author(s):  
ER Eichner ◽  
CJ Paine ◽  
VL Dickson ◽  
MD Jr Hargrove
Keyword(s):  
Binding Protein ◽  
Elevated Serum ◽  
Normal Subjects ◽  
Serum Levels ◽  
Serum Folate ◽  
Folate Level ◽  
Folate Binding Protein ◽  
Serum Folate Level ◽  
Relationship Of ◽  
The Relationship

Abstract We studied the effect of serum folate-binding protein (FBP) on folate radioassays and the relationship of the serum level of unsaturated FBP to the serum folate level in various clinical states. Our modification of a heat-extracted radioassay was compared to a whole serum radioassay. Our results confirmed the existence of elevated serum levels of unsaturated FBP in some normal subjects, in some women taking oral contraceptives, and in most patients with uremia. Elevated levels of unsaturated FBP will produce falsely low results in folate radioassay unless the FBP has been destroyed by heat, as was done in the modified radioassay here presented. In normal and uremic subjects, serum folate and unsaturated FBP levels tended to correlate, whereas in patients taking large doses of folic acid the level of unsaturated FBP fell as the level of serum folate rose.

scholarly journals Diabetic cardiomyopathy: factual or factoid?

2019 ◽  
Vol 65 (1) ◽  
pp. 61-69
Author(s):  
Thiago Quinaglia ◽  
Daniela C. Oliveira ◽  
José Roberto Matos-Souza ◽  
Andrei C. Sposito
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Diabetic Cardiomyopathy ◽  
Glucose Transporter ◽  
Epidemiological Evidence ◽  
Glucose Lowering ◽  
Reduced Ejection Fraction ◽  
Prevention And Treatment ◽  
Relationship Of ◽  
The Relationship

SUMMARY Although long ago described, there is no established consensus regarding the real existence of Diabetic Cardiomyopathy (CMPDM). Due to its complex pathophysiology, it has been difficult for clinical and experimental research to establish clear connections between diabetes mellitus (DM) and heart failure (HF), as well as to solve the mechanisms of the underlying myocardial disease. However, the epidemiological evidence of the relationship of these conditions is undisputed. The interest in understanding this disease has intensified due to the recent results of clinical trials evaluating new glucose-lowering drugs, such as sodium-glucose transporter inhibitors 2, which demonstrated favorable responses considering the prevention and treatment of HF in patients with DM. In this review we cover aspects of the epidemiology of CMPDM and its possible pathogenic mechanisms, as well as, present the main cardiac phenotypes of CMPDM (HF with preserved and reduced ejection fraction) and implications of the therapeutic management of this disease.

scholarly journals Pressure–volume loop validation of TAPSE/PASP for right ventricular arterial coupling in heart failure with pulmonary hypertension

2020 ◽  
Author(s):  
Alexander Schmeisser ◽  
Thomas Rauwolf ◽  
Thomas Groscheck ◽  
Siegfried Kropf ◽  
Blerim Luani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Characteristic Analysis ◽  
Reduced Ejection Fraction ◽  
Prognostic Assessment ◽  
Relationship Of ◽  
The Relationship

Abstract Aims The aim of this study was to validate the tricuspid annular plane systolic excursion/systolic pulmonary artery (PA) pressure (TAPSE/PASP) ratio with the invasive pressure–volume (PV) loop-derived end-systolic right ventricular (RV) elastance/PA elastance (Ees/Ea) ratio in patients with heart failure with reduced ejection fraction (HFREF) and secondary pulmonary hypertension (PH). Methods and results The relationship of TAPSE and TAPSE/PASP with RV-PV loop (single-beat)-derived contractility Ees, afterload Ea, and Ees/Ea was assessed in 110 patients with HFREF with and without secondary PH. The results were compared with other surrogate parameters such as the fractional area change/PASP ratio. The association of the surrogates with all-cause mortality was evaluated. In patients with PH (n = 74, 67%), TAPSE significantly correlated with Ees (r = 0.356), inverse with Ea (r = −0.514) but was most closely associated with Ees/Ea (r = 0.77). Placing TAPSE in a ratio with PASP slightly reduced the relationship to Ees/Ea (r = 0.71) but was more closely related to the parameters of PA vascular load, diastolic RV function, and RV energetics. The area under the curve of TAPSE/PASP and TAPSE for discriminating overall survival in receiver operating characteristic analysis was not different (P = 0.78. Prognostic relevant cut-offs were 17 mm for TAPSE and 0.38 mm/mmHg for TAPSE/PASP. Both parameters in multivariate cox regression remained independently prognostically relevant. Conclusion TAPSE is an easily and reliably obtainable and valid surrogate parameter for RV–PA coupling in PH due to HFREF. Putting TAPSE into a ratio with PASP did not further improve the coupling information or prognostic assessment. Trial Identifier DRKS—German Clinical Trials Register (DRKS00011133; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011133).

scholarly journals Neprilysin as a Biomarker: Challenges and Opportunities

2020 ◽  
Vol 6 ◽  
Author(s):  
Noemi Pavo ◽  
Suriya Prausmüller ◽  
Philipp E Bartko ◽  
Georg Goliasch ◽  
Martin Hülsmann
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Ectodomain Shedding ◽  
Reduced Ejection Fraction ◽  
Challenges And Opportunities ◽  
Inflammatory State ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Neprilysin (NEP) inhibition is a successful novel therapeutic approach in heart failure with reduced ejection fraction. Assessing individual NEP status might be important for gathering insights into mechanisms of disease and optimising individualised patient care. NEP is a zinc-dependent multisubstrate-metabolising oligoendopeptidase localised in the plasma membrane with the catalytic site facing the extracellular space. Although NEP activity in vivo is predominantly tissue-based, NEP can be released into the circulation via ectodomain shedding and exosomes. Attempts to determine circulating NEP concentrations and activity have not yet resulted in convincingly coherent results relating NEP biomarkers to heart failure disease severity or outcomes. NEP is naturally expressed on neutrophils, opening up the possibility of measuring a membrane-associated form with integrity. Small studies have linked NEP expression on neutrophils with inflammatory state and initial data might indicate its role in heart failure with reduced ejection fraction. Future studies need to assess the regulation of systemic NEP activity, which is assumed to be tissue-based, and the relationship of NEP activation with disease state. The relationship between tissue NEP activity and easily accessible circulating NEP biomarkers and the impact of the latter remains to be established.

scholarly journals Clinical and laboratory observations on serum folate-binding protein

Blood ◽  
1975 ◽  
Vol 46 (4) ◽  
pp. 599-609
Author(s):  
ER Eichner ◽  
CJ Paine ◽  
VL Dickson ◽  
MD Jr Hargrove
Keyword(s):  
Binding Protein ◽  
Elevated Serum ◽  
Normal Subjects ◽  
Serum Levels ◽  
Serum Folate ◽  
Folate Level ◽  
Folate Binding Protein ◽  
Serum Folate Level ◽  
Relationship Of ◽  
The Relationship

We studied the effect of serum folate-binding protein (FBP) on folate radioassays and the relationship of the serum level of unsaturated FBP to the serum folate level in various clinical states. Our modification of a heat-extracted radioassay was compared to a whole serum radioassay. Our results confirmed the existence of elevated serum levels of unsaturated FBP in some normal subjects, in some women taking oral contraceptives, and in most patients with uremia. Elevated levels of unsaturated FBP will produce falsely low results in folate radioassay unless the FBP has been destroyed by heat, as was done in the modified radioassay here presented. In normal and uremic subjects, serum folate and unsaturated FBP levels tended to correlate, whereas in patients taking large doses of folic acid the level of unsaturated FBP fell as the level of serum folate rose.

Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Biomarkers ◽  
Double Blind Study ◽  
Short Term ◽  
Double Blind ◽  
Reduced Ejection Fraction ◽  
The Mean ◽  
Design And Methods ◽  
The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

scholarly journals Relationship of anemia and clinical outcome in heart failure patients with preserved versus reduced ejection fraction in a rural area of Thailand

2020 ◽  
Vol 30 ◽  
pp. 100597
Author(s):  
Kittayaporn Chairat ◽  
Wipharak Rattanavipanon ◽  
Krittika Tanyasaensook ◽  
Busba Chindavijak ◽  
Suvatna Chulavatnatol ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcome ◽  
Ejection Fraction ◽  
Rural Area ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Relationship Of

scholarly journals Assessment of the relationship of serum liver enzymes activity with general and abdominal obesity in an urban Bangladeshi population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nurshad Ali ◽  
Abu Hasan Sumon ◽  
Khandaker Atkia Fariha ◽  
Md Asaduzzaman ◽  
Rahanuma Raihanu Kathak ◽  
...  
Keyword(s):  
General Population ◽  
Abdominal Obesity ◽  
Liver Enzymes ◽  
Serum Levels ◽  
General Obesity ◽  
Enzymes Activity ◽  
Elevated Liver Enzymes ◽  
Bangladeshi Population ◽  
Relationship Of ◽  
The Relationship

AbstractObesity is a global health concern because of its increasing trend both in developed and developing countries. A limited number of studies have evaluated the association of liver enzymes with both general and abdominal obesity in the general population; data for the Bangladeshi population are not available yet. This study aimed to assess the relationship of serum liver enzymes activity with both general and abdominal obesity in Bangladeshi adults. In total, 540 blood samples were obtained from the participants (388 males and 152 females) and analyzed for serum levels of ALT, AST, GGT, and ALP using standard methods. General obesity was defined as body mass index (BMI) ≥ 27.5 kg/m2 and abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in males and ≥ 80 cm in females. The relationship between liver enzymes and obesity was evaluated by multivariate logistic regression models. Overall, 58% of participants in the general obesity group and 55% of the participants in the abdominal obesity group had at least one or more elevated levels of liver enzymes. The prevalence of elevated liver enzymes was significantly higher in the obesity group compared to the normal BMI and WC groups (p < 0.05 for all cases). The mean level of serum ALT, AST and GGT were significantly higher in the obesity group than the normal BMI group (p < 0.05). In the WC groups, mean AST and GGT were significantly higher in the obesity group compared to the normal group (p < 0.05). In regression analysis, serum levels of ALT showed an independent and significant association with general obesity, whereas, serum GGT showed a significant association with both general and abdominal obesity. In conclusion, a high prevalence of elevated liver enzymes was observed among participants included in the present study. Of the four enzymes, serum GGT was independently associated with both general and abdominal obesity. Further studies are required to understand the complex relationship between liver enzymes and obesity in the general population.

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