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Serum Levels of Irisin Are Positively Associated with Improved Cardiac Function in Patients with Heart Failure with
Alexander E Berezin1, Tetiana A Berezina2, Evgen V Novikov3
1Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria.
Insights
Higher levels of the biomarker irisin may predict improved heart function in heart failure patients. This study found that serum irisin levels of at least 10.8 ng/mL independently predicted improved left ventricular ejection fraction in patients with heart failure with reduced ejection fraction.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Management
Background:
- Heart failure with reduced ejection fraction (HFrEF) is a chronic condition requiring effective management strategies.
- Identifying predictors of left ventricular ejection fraction (LVEF) improvement is crucial for optimizing patient outcomes.
- Irisin, a myokine, is being investigated for its potential role in cardiovascular health.
Purpose of the Study:
- To evaluate the predictive value of serum irisin levels for improved LVEF in patients discharged with HFrEF.
- To compare the predictive performance of irisin against established biomarkers like NT-proBNP.
Main Methods:
- A cohort of 313 HFrEF patients (LVEF ≤ 40%) was monitored for 3 months post-discharge.
- Improved LVEF (HFimpEF) was defined as a >40% increase in LVEF.
- Serum irisin and NT-proBNP levels were measured at baseline and follow-up.
Main Results:
- Patients with HFimpEF (n=117) exhibited higher irisin levels compared to those with persistent HFrEF (n=196).
- Multivariate analysis identified serum irisin ≥ 10.8 ng/mL as an independent predictor of HFimpEF.
- Irisin demonstrated superior discriminative ability compared to NT-proBNP for predicting LVEF improvement.
Conclusions:
- Serum irisin ≥ 10.8 ng/mL is a significant independent predictor of HFimpEF in HFrEF patients.
- Irisin offers a valuable prognostic marker for LVEF recovery, potentially independent of natriuretic peptides.
- These findings suggest irisin could be a novel therapeutic target or diagnostic tool in heart failure management.
Abstract:
Background: The purpose of the study is to investigate a possible predictive value of irisin for improved left ventricular (LV) ejection fraction (EF) in discharged patients with known heart failure with reduced ejection fraction (HFrEF). Methods: We included in the study 313 patients who were discharged with HFrEF (at admission, LVEF ≤ 40%) and monitored for 3 months. HF with improved LVEF (HFimpEF) was characterized as a >40% increase in LVEF on transthoracic B-mode echocardiography within 3 months of follow-up. Circulating biomarkers including NT-proBNP and irisin were detected at baseline and after 3 months of observation. By the third month, 117 (37.4%) patients had HFimpEF, whereas 196 individuals were categorized as having persistent HFrEF. Results: We found that HFimpEF was related to lower LV end-diastolic dimensions and concentrations of NT-proBNP and higher left atrial volume index (LAVI) and irisin concentrations than those with persistent HFrEF. The most balanced cut-offs of irisin and NT-proBNP concentrations (improved LVEF versus non-improved LVEF) were 10.8 ng/mL and 1540 pmol/L, respectively. Multivariate regression analysis showed that atrial fibrillation (odds ratio [OR] = 0.95; p = 0.010), LAVI < 39 mL/m2 (OR = 1.23; p = 0.001), irisin levels ≥ 10.8 ng/mL (OR = 1.73; p = 0.001), and NT-proBNP < 1540 pmol/mL (OR = 1.47; p = 0.001) independently predicted HFimpEF. The discriminative ability of irisin ≥ 10.8 ng/mL was better than NT-proBNP < 1540 pmol/mL; the predictive ability of irisin alone was not improved by the combined model (irisin added to NT-proBNP). Conclusions: serum irisin ≥ 10.8 ng/mL predicted HFimpEF independently of natriuretic peptide in HFrEF patients.
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