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Published on: May 28, 2019
Circulating Chromogranin B Is Associated With Left Ventricular Functional Recovery After Successful Recanalization of
Ying Shen1, Muladili Aihemaiti2, Xin Yi Shu2
1Department of Cardiovascular Medicine, Rui Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Insights
Elevated Chromogranin B (CgB) levels indicate a higher risk of impaired left ventricular (LV) functional recovery after chronic total occlusion (CTO) recanalization in stable coronary artery disease patients.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Chromogranin B (CgB) levels correlate with heart failure severity.
- CgB's role in predicting left ventricular (LV) functional recovery post-recanalization is unclear.
Purpose of the Study:
- To investigate the association between circulating CgB levels and LV functional recovery potential.
- To determine if CgB can predict LV ejection fraction (EF) improvement after chronic total occlusion (CTO) recanalization.
Main Methods:
- Serum CgB levels were measured in 53 patients with LV functional recovery and 53 controls post-CTO recanalization.
- Left ventricular ejection fraction (LVEF) changes were assessed over a 12-month follow-up.
- Receiver operating characteristic (ROC) analysis was used to evaluate CgB's predictive performance.
Main Results:
- CgB levels were significantly lower in the recovery group (593 pg/ml) versus the non-recovery group (1,108 pg/ml).
- CgB was inversely correlated with LVEF changes (r = -0.31, P = 0.001).
- CgB demonstrated good predictive value for LVEF improvement (AUC = 0.76) with an optimal cutoff of 972.5 pg/ml.
Conclusions:
- Elevated CgB is an independent predictor of impaired LV functional recovery after CTO recanalization.
- Higher CgB levels are associated with a greater risk of poor LV functional recovery.
- LV functional improvement response to CgB may differ based on coronary collateral status.
Abstract:
Background: Chromogranin B (CgB) is increased in heart failure and proportionate to disease severity. We investigated whether circulating CgB level is associated with left ventricular (LV) functional recovery potential after successful recanalization of chronic total occlusion (CTO). Methods: Serum levels of CgB were assayed in 53 patients with stable angina with LV functional recovery [an absolute increase in LV ejection fraction (EF) of ≥5%] and 53 age- and sex-matched non-recovery controls after successful recanalization of CTO during 12-month follow-up. Results: We found that CgB level was significantly lower in the recovery group than in the non-recovery group (593 [IQR 454-934] vs. 1,108 [IQR 696-2020] pg/ml, P < 0.001), and that it was inversely correlated with changes in LVEF (Spearman's r = -0.31, P = 0.001). Receiver operating characteristic (ROC) analysis showed that the area under the curve of CgB for predicting LVEF improvement was 0.76 (95% CI 0.664-0.856), and that the optimal cutoff value was 972.5 pg/ml. In multivariate analyses, after adjusting for confounding factors, high CgB level remained an independent determinant of impaired LV functional recovery after CTO recanalization. LV functional improvement appeared to be more responsive to CgB in patients with poor than with good coronary collaterals. Conclusions: Elevated circulating CgB level confers an increased risk of impaired LV functional recovery after successful recanalization of CTO in patients with stable coronary artery disease.
