Complement C3c as a biomarker in heart failure
A Frey1, G Ertl1, C E Angermann1
1Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany ; Comprehensive Heart Failure Center, University of Würzburg, Straubmühlweg 2a, Haus A9, 97078 Würzburg, Germany.
Insights
Elevated C3c complement levels in heart failure (HF) patients may indicate better survival and less adverse cardiac remodeling. This finding suggests C3c could be a useful prognostic marker in stable systolic HF.
Area of Science:
- Immunology
- Cardiology
- Biomarkers
Background:
- The innate immune system, particularly complement, plays a role in cardiac remodeling and heart failure (HF).
- Complement-deficient animals show protection against adverse cardiac remodeling.
- Peripheral complement levels are hypothesized as potential markers for HF prognosis.
Purpose of the Study:
- To investigate the association between peripheral complement levels and adverse remodeling/prognosis in patients with stable systolic HF.
- To evaluate serum C3c as a potential biomarker in heart failure.
Main Methods:
- Serum C3c levels were measured in 197 patients with stable systolic HF.
- Patients were subgrouped based on normal versus elevated C3c levels.
- Clinical parameters including survival, LVEF, NTpro-BNP, and comorbidities were analyzed.
Main Results:
- Elevated C3c levels were observed in 17% of the HF cohort.
- Patients with elevated C3c showed a trend towards better survival, higher LVEF, and lower NTpro-BNP.
- Elevated C3c was associated with a higher prevalence of preexisting diabetes but not other common HF comorbidities.
Conclusions:
- Elevated serum C3c levels are linked to less adverse cardiac remodeling in stable systolic heart failure.
- Higher C3c levels correlate with improved survival outcomes in this patient group.
- C3c shows potential as a prognostic biomarker for heart failure.
Introduction:
Experimental data indicates an important role of the innate immune system in cardiac remodeling and heart failure (HF). Complement is a central effector pathway of the innate immune system. Animals lacking parts of the complement system are protected from adverse remodeling. Based on these data, we hypothesized that peripheral complement levels could be a good marker for adverse remodeling and prognosis in patients with HF.
Methods And Results:
Since complement activation converges on the complement factor C3, we measured serum C3c, a stable C3-conversion product, in 197 patients with stable systolic HF. Subgroups with normal and elevated C3c levels were compared. C3c levels were elevated in 17% of the cohort. Patients with elevated C3c levels exhibited a trend to better survival, slightly higher LVEF, and lower NTpro-BNP values in comparison to patients with normal C3c values. No differences were found regarding NYHA functional class. Significantly more patients with elevated C3c had preexisting diabetes. The prevalence of CAD, arterial hypertension, and atrial fibrillation was not increased in patients with elevated C3c.
Conclusion:
Elevated C3c levels are associated with less adverse remodeling and improved survival in patients with stable systolic heart failure.
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