Circulating multimarker approach to identify patients with preclinical left ventricular remodelling and/or diastolic...

Area of Science:

• Cardiology
• Biomarker Research
• Population Health

Background:

• Myocardial fibrosis and inflammation biomarkers are linked to left ventricular hypertrophy (LVH) and diastolic dysfunction (DD).
• The combined predictive value of these biomarkers for LVH and DD in population studies remains under-investigated.

Purpose of the Study:

• To assess the added value of a multimarker strategy (BNP, Galectin-3, P3NP, ST2) in detecting LVH and DD within a large population-based cohort.
• To evaluate the predictive performance of these biomarkers using discrimination and reclassification analyses.

Main Methods:

• Analysis of the STANISLAS cohort (1705 subjects).
• Evaluation of brain natriuretic peptide (BNP), Galectin-3 (GAL3), N-terminal propeptide of procollagen type III (P3NP), and soluble ST2.
• Utilized discrimination (C-index) and reclassification (NRI) to assess predictive ability for LVH and DD.

Main Results:

• Subjects with LVH and/or DD showed elevated BNP, GAL3, and ST2 levels.
• The addition of the four biomarkers significantly improved the prediction of LVH (delta C-index = 0.03) and DD (delta C-index = 0.01) over clinical variables.
• Gal3, P3NP, and ST2 notably enhanced DD prediction (NRI = 31.3) beyond clinical factors and BNP.

Conclusions:

• A multimarker approach offers a moderate but significant improvement in predicting LVH and DD in population studies.
• The incremental predictive gain from Gal3, P3NP, and ST2 for preclinical DD in unselected individuals is marginal.
• Further research into personalized medicine approaches combining proteomic and clinical data is warranted to enhance the detection of preclinical DD.