Urinary proteome analysis in hypertensive patients with left ventricular diastolic dysfunction.

Area of Science:

• Biochemistry
• Cardiology
• Biomarker Discovery

Background:

• Heart failure (HF) presents a significant societal burden, yet early detection of asymptomatic left ventricular (LV) dysfunction remains challenging.
• Current screening methods lack easy applicability for identifying early-stage LV dysfunction, particularly diastolic dysfunction.

Purpose of the Study:

• To identify and validate urinary polypeptides as biomarkers for early detection of LV diastolic dysfunction in hypertensive patients.
• To assess the potential of these biomarkers in distinguishing between patients with and without LV diastolic dysfunction.

Main Methods:

• Capillary electrophoresis coupled to mass spectrometry was used to analyze urinary polypeptides.
• A cross-sectional case-control study nested within the FLEMENGHO cohort was conducted.
• A high-dimensional classifier model was developed using identified potential biomarkers.

Main Results:

• Initially, 85 urinary peptides differed between hypertensive patients with LV diastolic dysfunction and controls (P<0.033).
• After adjusting for multiple testing, three potential biomarkers remained significant (P≤0.02).
• A classifier model achieved an AUC of 0.84 (95% CI: 0.70-0.98; P=0.001) in distinguishing symptomatic HF patients from controls.

Conclusions:

• A specific set of urinary polypeptides was identified in asymptomatic hypertensive patients with LV diastolic dysfunction.
• These biomarkers can differentiate essential hypertension with LV diastolic dysfunction and distinguish overt heart failure patients from healthy individuals.