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Ceruloplasmin as Redox Marker Related to Heart Failure Severity
Elżbieta Lazar-Poloczek1, Ewa Romuk2, Piotr Rozentryt3,4
1Second Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, M. C. Skłodowskiej 10 Street, 41-800 Zabrze, Poland.
Insights
Ceruloplasmin (CER) levels correlate with exercise capacity and disease severity in heart failure with reduced ejection fraction (HFrEF). Higher CER predicts poorer exercise performance, suggesting its utility as a biomarker.
Area of Science:
- Cardiology
- Exercise Physiology
- Biochemistry
Background:
- Heart failure with reduced ejection fraction (HFrEF) is a complex condition.
- Cardiopulmonary exercise testing (CPET) is crucial for assessing functional capacity in HFrEF.
- Biomarkers are needed to better understand disease progression and prognosis.
Purpose of the Study:
- To investigate the relationship between ceruloplasmin (CER) levels and CPET parameters in HFrEF patients.
- To explore correlations between CER and various clinical, inflammatory, and redox biomarkers.
- To assess CER's predictive value for exercise capacity in HFrEF.
Main Methods:
- A cohort of 552 HFrEF patients was analyzed.
- Patients were classified based on Weber's classification using peak VO2.
- Statistical analyses identified correlations and predictive variables for CER concentration.
Main Results:
- Higher CER levels were observed in patients with lower peak VO2 (< 16 mL/kg/min) and higher VE/CO2 slope (> 45).
- CER positively correlated with NYHA class, RV diameter, NT-proBNP, uric acid, total protein, fibrinogen, hepatic enzymes, TOS, TAC, and malondialdehyde.
- Total oxidant status (TOS), malondialdehyde, and alkaline phosphatase independently predicted CER concentration.
- CER was an independent predictor of peak VO2 ≤ 12 mL/kg/min.
Conclusions:
- Ceruloplasmin is associated with impaired exercise capacity and disease severity in HFrEF.
- CER correlates with markers of inflammation, oxidative stress, and hepatic function.
- CER may serve as a valuable prognostic biomarker in HFrEF management.
Abstract:
This study examined ceruloplasmin levels in patients with HFrEF, depending on cardiopulmonary exercise testing (CPET) parameters; a correlation was found between ceruloplasmin (CER) and iron and hepatic status, inflammatory and redox biomarkers. A group of 552 patients was divided according to Weber's classification: there were 72 (13%) patients in class A (peak VO2 > 20 mL/kg/min), 116 (21%) patients in class B (peak VO2 16-20 mL/kg/min), 276 (50%) patients in class C (peak VO2 10-15.9 mL/kg/min) and 88 (16%) patients in class D (peak VO2 < 10 mL/kg/min). A higher concentration of CER was found in patients with peak VO2 < 16 mL/kg/min and VE/CO2 slope > 45 compared to patients with VE/CO2 slope < 45 (escectively CER 30.6 mg/dL and 27.5 mg/dL). A significantly positive correlation was found between ceruloplasmin and NYHA class, RV diameter, NT-proBNP, uric acid, total protein, fibrinogen and hepatic enzymes. CER was positively correlated with both total oxidant status (TOS), total antioxidant capacity (TAC) and malondialdehyde. A model constructed to predict CER concentration indicated that TOS, malondialdehyde and alkaline phosphatase were independent predictive variables (R2 0.14, p < 0.001). CER as a continuous variable was an independent predictor of pVO2 ≤ 12 mL/kg/min after adjustment for sex, age and BMI. These results provide the basis of a new classification to encourage the determination of CER as a useful biomarker in HFrEF.
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