Author + information
- Evangelos Oikonomou,
- Efstathios Dimitropoulos,
- Gerasimos Siasos,
- Antigoni Miliou,
- Christine Chrysohoou,
- Konstantinos Mourouzis,
- Georgia Vogiatzi,
- Alexios Antonopoulos,
- Mpourouki Evgenia,
- Sotirios Tsalamandris,
- George-Angelo Papamikroulis,
- Charilila-Loukia Ververeli and
- Dimitris Tousoulis
Background: Adrenomedullin (ADM) is involved in vascular homeostasis and endothelial function. A-type natriuretic peptide (ANP) has potent diuretic, and vasodilating actions. Mid regional epitopes of these peptides (MR-proANP and MR-proADM) present increased plasma stability. Soluble suppression of tumorigenicity 2 (sST2) has emerged as a novel biomarker for HF, and has been identified as a novel biomarker of cardiac stress, fibrosis and remodeling. Endothelial dysfunction in HF patients may be associated with markers of myocardial strain and fibrosis.
Methods: In this cohort study we enrolled 75 consecutive patients with stable chronic systolic HF in NYHA class 2 to 4 and 80 matched for age and sex control subjects. Endothelial function was evaluated by flow-mediated dilatation (FMD). Serum levels of MR-proANP and MR-proADMand sST2 were measure with ELISA. Several other clinical and demographic characteristics were also collected.
Results: There was no difference in age (64±10y vs 65±11y, p=0.67) and male gender (64% vs. 67%, p=0.78) between control and HF subjects. Subjects with HF had significantly impaired FMD compared to control subjects (4.95±2.28% vs. 6.12±3.12%, p=0.04). In HF patients FMD was inversely associated with sST2 levels (rho=-0.57, p<0.001) and with MR-proADM levels (rho=-0.26, p=0.02) while there was no association of MR-proANP with FMD (rho=0.09, p=0.94). In HF patients FMD was significantly associated with age (r=-19, p=0.04), while there was no association of FMD with ejection fraction (r=0.037, p=0.65), with NYHA status (r=0.04, p=0.70) and with creatinine levels (r=0.06, p=0.34). Interestingly, after adjustment for multiple established confounders (age, ejection fraction, NYHA status, smoking status, gender and the use of mineralocorticoid receptor antagonists, angiotensin receptor blockers or angiotensin converting enzyme inhibitors) sST2 was independently and strongly associated with FMD in patients with HF [b=-0.17 95%CI (-0.22, −0.05), p=0.05].
Conclusions: These findings confirm the complex interrelationship between inflammation, left ventricle strain, myocardial fibrosis and endothelial dysfunction in patients with heart failure.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Diabetes and Endothelial Dysfucntion in Heart Failure
Abstract Category: 12. Heart Failure and Cardiomyopathies: Basic
Presentation Number: 1162-246
- 2017 American College of Cardiology Foundation