Diagnostic Value of Biochemical Markers in Patients With Chronic Heart Failure With Reduced, Borderline and Preserved Left Ventricular Ejection Fraction

• Published in: Kardiologiia Vol. 57; no. 3; p. 39
• Main Authors: Bazaeva, E V, Myasnikov, R P, Metelskaya, V A, Boytsov, S A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01.03.2017
• Subjects: Adiponectin; Adult; Aged; Aged, 80 and over; Biomarkers; Chronic Disease; Cross-Sectional Studies; Echocardiography; Female; Galectin 3; Growth Differentiation Factor 15; Heart Failure - diagnosis; Heart Failure - metabolism; Heart Failure - physiopathology; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; ROC Curve; Stroke Volume; Ventricular Function, Left; a growth differentiation factor-15; adiponectin; natriuretic peptides; pentraxins-3; chronic heart failure with preserved left ventricular ejection fraction; pentraxin 3; chronic heart failure; biochemical markers; galectin-3; left ventricular ejection fraction
• ISSN: 0022-9040
• DOI: 10.18565/cardio.2017.3.39-45

The study of the diagnostic value of biochemical markers of myocardial stress and inflammation in chronic heart failure (CHF) with different values of the ejection fraction (EF) of the left ventricle (LV). The cross-sectional study included 105 patients aged 24 to 84 years (mean 58+/-14 years) with stable chronic heart failure I-II NYHA functional class classification. The causes of CHF were ischemic heart disease (IHD) in 33% of patients and arterial hypertension (AH) - 67%. All patients received medical treatment: angiotensin-converting enzyme (ACE) - 76%, -blockers - 72%, diuretics - 100%, statins - 80%. The control group consisted of 35 healthy volunteers. All subjects identified blood natriuretic peptide (NT-proBNP, ANP), adiponectin, galectin-3, pentraxins-3 and growth differentiation factor-15 (GDF-15) by enzyme immunoassay (ELISA). All surveyed performed transthoracic echocardiography (Echo). The blood NT-proBNP, ANP, galectin-3, pentraxins and GDF-3-15 in patients with chronic heart failure was significantly higher than in the control group (p<0.001 in all cases). In contrast, the level of adiponectin was significantly higher than in healthy individuals - 11.90 (11.39; 12.65) vs 7.73 (3.58; 8.86) ng/ml in patients with chronic heart failure (p<0.001). LVEF ranged from 30 to 55%, in 33% of patients it was >50%. Correlation analysis Spearman found strong correlations (p<0.001 for all markers) between LVEF and the content of all the biomarkers, while between the PV and the level of adiponectin is a positive correlation was found (r=0.862), and between the PV and the other biomarkers - reverse (r from -0.858 to -0.901). Multivariate linear regression analysis found the strongest correlation with the value of LVEF at pentraxin 3 and adiponectin. Subsequent ROC-analysis confirmed the diagnostic value of adiponectin in patients with heart failure and preserved ejection fraction. Thus, the level of adiponectin more than 8.3 ng/ml served as a prognostic factor for the presence of heart failure in patients with LVEF >50% with a sensitivity of 94.3% and a specificity of 92.9% (area under the curve 0.977; 95% confidence interval from 0.954 to 0.999; p<0.001). Among the 6 studied biomarkers of myocardial stress and inflammation only adiponectin has diagnostic significance in patients with heart failure and preserved ejection fraction.