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Urinary Marker Profiles in Heart Failure with Reduced Versus Preserved Ejection Fraction
Koen W Streng1, Hans L Hillege1, Jozine M Ter Maaten1
1Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
Journal of Cardiovascular Translational Research
|February 16, 2023
Summary
Heart failure with preserved ejection fraction (HFpEF) patients show more tubular damage than those with reduced ejection fraction (HFrEF), especially with normal kidney function. Urinary markers reveal distinct renal dysfunction causes in HFpEF versus HFrEF.
Area of Science:
- Nephrology
- Cardiology
- Biomarker Discovery
Background:
- Renal dysfunction presents differently in heart failure with reduced ejection fraction (HFrEF) versus preserved ejection fraction (HFpEF).
- Urinary markers offer insights into specific nephron segments affected in heart failure patients.
Purpose of the Study:
- To investigate distinct causes of renal dysfunction in HFrEF versus HFpEF.
- To analyze a range of urinary markers reflecting different nephron segments in heart failure patients.
Main Methods:
- Measured established and novel urinary markers in 2070 chronic heart failure patients.
- Assessed markers reflecting different nephron segments to differentiate renal dysfunction.
Main Results:
- HFpEF patients exhibited higher urinary NGAL and KIM-1 levels compared to HFrEF patients.
- These differences were more pronounced in HFpEF patients with preserved estimated glomerular filtration rate (eGFR).
- HFpEF patients had a lower mean eGFR than HFrEF patients.
Conclusions:
- HFpEF patients demonstrate greater evidence of tubular damage or dysfunction compared to HFrEF patients.
- Tubular dysfunction in HFpEF is particularly notable when glomerular function remains preserved.
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