CILP-1 Is a Biomarker for Backward Failure and Right Ventricular Dysfunction in HFrEF

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Heart Failure Research

Background:

• Cartilage intermediate layer protein-1 (CILP-1) is implicated in myocardial fibrosis and remodeling.
• Previous research suggests CILP-1 indicates right ventricular dysfunction (RVD) in pulmonary hypertension (PH) and heart failure (HF).

Purpose of the Study:

• To investigate CILP-1 as a potential biomarker for RVD in patients with heart failure with reduced ejection fraction (HFrEF).
• To assess the prognostic value of CILP-1 for mortality and hospitalization in HFrEF patients on guideline-directed medical therapy.

Main Methods:

• CILP-1 levels were measured in 610 HFrEF patients from a prospective registry (2016-2022).
• Correlations with echocardiographic and hemodynamic data were analyzed.
• Association with RVD, mortality, and cardiovascular hospitalization was evaluated.

Main Results:

• CILP-1 levels increased with HF severity, correlating with NT-proBNP and NYHA class.
• CILP-1 showed associations with backward failure indicators (e.g., elevated left atrial diameter, sPAP, RVF) but not cardiac index or SVR.
• CILP-1 trended as a risk factor for all-cause mortality but lost significance after adjustment for NT-proBNP.

Conclusions:

• CILP-1 correlates with HFrEF severity and backward failure, potentially indicating mortality risk, but is not an independent predictor.
• The association of CILP-1 with RVD warrants further investigation to determine if it stems from pulmonary pressures or is specific to RVD.