Cardiac Remodeling Biomarkers as Potential Circulating Markers of Left Ventricular Hypertrophy in Heart Failure with
Valentina T Mitic1, Dijana R Stojanovic2, Marina Z Deljanin Ilic1,3
1Institute for Treatment and Rehabilitation "Niska Banja".
Insights
Cardiac remodeling biomarkers like sST2 and galectin-3 show distinct levels across heart failure types. These markers correlate with left ventricular hypertrophy in heart failure with preserved ejection fraction (HFpEF), aiding disease progression recognition.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Pathophysiology
Background:
- Soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15, and syndecan-1 are established biomarkers of cardiac remodeling.
- These biomarkers are implicated in the progression of heart failure (HF), a condition characterized by impaired cardiac function.
- Brain natriuretic peptide (BNP) is a key neurohormone used in HF assessment.
Purpose of the Study:
- To investigate differences in plasma concentrations of sST2, galectin-3, GDF-15, and syndecan-1 across HF subtypes stratified by ejection fraction (EF).
- To assess correlations between these biomarkers and echocardiographic parameters indicative of left ventricular (LV) hypertrophy, including LV mass index (LVMI) and wall dimensions.
- To explore the relationship of these biomarkers with diastolic dysfunction.
Main Methods:
- Seventy-seven HF patients were categorized into reduced EF (<40%, HFrEF), mid-range EF (40-49%, HFmrEF), and preserved EF (>50%, HFpEF).
- Plasma concentrations of sST2, galectin-3, GDF-15, syndecan-1, and BNP were measured.
- Echocardiographic parameters including LVMI, posterior wall diameter, and septum diameter were assessed. Statistical analyses, including multivariable adjustments, were performed.
Main Results:
- Plasma concentrations of the four cardiac remodeling biomarkers were significantly higher in HFrEF and lower in HFpEF (p < 0.001).
- In HFpEF, sST2, galectin-3, GDF-15, and syndecan-1 independently correlated with LVMI. Galectin-3 also correlated after multivariable adjustments (p = 0.001).
- These biomarkers also independently correlated with septum and posterior wall diameters in HFpEF. GDF-15 showed correlation with diastolic dysfunction in both HFpEF (p = 0.046) and HFrEF (p = 0.024).
Conclusions:
- Cardiac remodeling biomarkers serve as potential circulating indicators of LV hypertrophy in HFpEF.
- These biomarkers may facilitate the timely identification of disease progression in high-risk HFpEF patients.
- BNP correlated with LVMI and EF in HFrEF, highlighting its role in this HF subtype.
Abstract:
Soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1 represent biomarkers of cardiac remodeling, involved in heart failure (HF) progression. We hypothesize that their plasma concentrations, together with brain natriuretic peptide (BNP), are different in HF stratified by ejection fraction (EF), demonstrating correlations with echocardiographic parameters that indicate left ventricular (LV) hypertrophy; LV mass index (LVMI) and posterior wall and septum diameters. HF patients (n = 77) were classified according to EF: reduced EF < 40% (HFrEF), mid-range EF = 40-49% (HFmrEF), preserved EF > 50% (HFpEF). We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p < 0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p = 0. 002), galectin-3 (p < 0.001), GDF-15 (p = 0.011), and syndecan-1 (p = 0.006), whereas galectin-3 correlated after multivariable adjustments (p = 0.001). Independent correlates of septum and posterior wall diameters, in HFpEF, were sST2 (p = 0.019; p = 0.026), galectin-3 (p = 0.011; p = 0.009), GDF-15 (p = 0.007; p = 0.001), and syndecan-1 (p = 0.005; p = 0.002). In HFrEF, only sST2, adjusted, correlated with LVMI (p = 0.010), whereas BNP correlated with LVMI (p = 0.002) and EF (p = 0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p = 0.046) and HFrEF (p = 0.024). Cardiac remodeling biomarkers are potential circulating indicators of LV hypertrophy in HFpEF, which may ensure timely recognition of disease progression among high-risk patients.
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