Usefulness of the Hepatocyte Growth Factor as a Predictor of Mortality in Patients Hospitalized with Acute Heart Failure Regardless of Ejection Fraction

• Published in: The American journal of cardiology Vol. 118; no. 4; pp. 543 - 549
• Main Authors: Pérez-Calvo, Juan-Ignacio, MD, PhD, Morales-Rull, José-Luis, MD, PhD, Gimeno-Orna, José-Antonio, MD, PhD, Lasierra-Díaz, Pilar, MD, PhD, Laorden, Claudia Josa, MD, Puente-Lanzarote, Juan-José, MD, PhD, Bettencourt, Paulo, MD, PhD, Pascual-Figal, Domingo A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.08.2016; Elsevier Limited
• Subjects: Acute coronary syndromes; Aged; Aged, 80 and over; Biomarkers - blood; Cardiac arrhythmia; Cardiovascular; Cardiovascular disease; Cause of Death; Cohort Studies; Confidence intervals; Diabetes; Dyspnea; Enzyme-Linked Immunosorbent Assay; Enzymes; Female; Fractions; Growth factors; Heart attacks; Heart failure; Heart Failure - blood; Heart Failure - mortality; Heart Failure - physiopathology; Hepatocyte Growth Factor - blood; Hospitalization; Humans; Hypertension; Kaplan-Meier Estimate; Kidney diseases; Laboratories; Male; Middle Aged; Mortality; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Prognosis; Proportional Hazards Models; Prospective Studies; Rodents; Stroke Volume; Variables; Hepatocyte Growth Factor; Heart Failure with Preserved Ejection Fraction; Heart Failure Prognosis; Acute Heart Failure
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.05.048

Abstract Hepatocyte Growth Factor (HGF) plays a role in the improvement of cardiac function and remodeling. Their serum levels are strongly related with mortality in chronic systolic heart failure (HF). Aim: to study prognostic value of HGF in acute HF, interaction with ejection fraction, renal function and natriuretic peptides. We included 373 patients (age 76±10 years, left ventricular ejection fraction [LVEF] 46±14%, 48% males) consecutively admitted for acute HF. Blood samples were obtained at admission. All patients were followed-up until death or close of study (>1 year, median 371 days). HGF concentrations were determined using a commercial ELISA (Human HGF Immunoassay, Abingdon, UK). The predictive power of HGF was estimated by Cox regression with calculation of Harrell C-statistic. HGF had a median of 1942 (IQR 1354) pg/mL. According to HGF quartiles, mortality rates (per 1000 patients/year) were 98, 183, 375 and 393 respectively (p<0.001). In Cox regression analysis, HGF (HR1SD =1.5, 95%CI 1.1-2.1, p=0.002) and NT-proBNP (HR1SD =1.8, 95%CI 1.2-2.6, p=0.002) were independent predictors of mortality. Interaction between HGF and LVEF, etiology and renal function was non-significant. The addition of HGF improved the predictive ability of the models (C-statistic 0.768 vs 0.741; p=0.016). HGF showed a complementary value over NT-proBNP (p=0.001): mortality rate was 490 with both above the median vs. 72 with both below. In conclusion, in patients with acute HF, serum HGF concentrations are elevated and identify patients at higher risk of mortality, regardless of LVEF, ischemic etiology or renal function. HGF had independent and additive information over NT-proBNP.