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Updated: Sep 11, 2025
A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
Published on: April 30, 2020
Emerging biomarkers for vascular remodeling in volume and pressure overload in a cardiology cohort
Dora Csengeri1,2, Daniel Engler1,2, Patricia Schlieker1,2
1Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.
Insights
Four circulating biomarkers, including angiopoietin-2 (ANGPT2) and fibroblast growth factor 23 (FGF23), are elevated in patients with volume overload and predict mortality. These markers may offer new diagnostic insights for cardiac conditions.
Area of Science:
- Cardiology
- Biomarker Discovery
- Vascular Biology
Background:
- Emerging evidence suggests circulating biomarkers like angiopoietin-2 (ANGPT2), bone morphogenetic protein-10 (BMP10), fibroblast growth factor 23 (FGF23), and insulin-like growth factor-binding protein 7 (IGFBP7) are linked to adverse cardiac remodeling.
- These biomarkers reflect distinct pathophysiological processes in the vasculature and heart, particularly in response to pressure or volume overload.
Purpose of the Study:
- To investigate the association between ANGPT2, BMP10, FGF23, and IGFBP7 and the presence of hemodynamically significant pressure or volume overload.
- To explore the relationship between these emerging biomarkers and adverse clinical outcomes, including all-cause mortality.
Main Methods:
- An observational cohort study was conducted with 1506 outpatient cardiology patients.
- Multivariable-adjusted regression models were employed to examine the relationship between the four biomarkers and pressure/volume overload.
Main Results:
- Elevated levels of all four biomarkers were positively associated with significant volume overload.
- FGF23 and NT-proBNP showed significant associations with pressure overload.
- Higher concentrations of all biomarkers predicted all-cause mortality in patients with volume overload.
Conclusions:
- Circulating biomarkers reflecting inflammation, fibrosis, and calcification pathways are elevated in patients with significant volume overload.
- These biomarkers, especially when considered with NT-proBNP, warrant further investigation for targeted clinical applications due to their association with mortality.
Abstract:
Emerging evidence indicates that the circulating biomarker angiopoietin-2 (ANGPT2), bone morphogenetic protein2 10 (BMP10), fibroblast growth factor 23 (FGF23), and insulin-like growth factor-binding protein7 (IGFBP7) reflect distinct pathophysiological vascular and cardiac processes contributing to adverse cardiac remodeling in the context of volume or pressure overload. This study aims to investigate the association between these circulating biomarkers, and the presence of hemodynamically significant pressure or volume overload and adverse clinical outcomes.
Methods:
In an observational cohort of outpatient cardiology patients (N = 1506) the relationship between the four emerging biomarkers and pressure/volume overload using multivariable-adjusted regression models was examined.
Results:
Elevated levels of the four biomarkers were positively associated with the presence of significant volume overload compared to none/mild valve disease. (ANGPT2: Odds ratio (OR) 1.26 (95 % confidence interval (CI): 1.17-1.35), p < 0.001; BMP10: OR = 2.57 (95 %-CI: 1.89-3.48), p < 0.001; FGF23: OR = 1.51 (95 %-CI: 1.14-1.20), p = 0.004; IGFBP7: OR = 1.39 (95 %-CI: 1.14-1.69), p = 0.001, NT-proBNP: OR = 1.69 (95 %-CI: 1.47-1.95), p < 0.001).FGF23 and NT-proBNP demonstrated statistically significant associations with pressure overload compared to none/mild burden.Higher concentrations of all biomarkers were predictive of all-cause mortality in patients with volume overload.
Conclusions:
This study highlights that circulating biomarkers associated with distinct pathophysiological vascular pathways, including inflammation, fibrosis, and calcification, are elevated in patients with hemodynamically significant volume overload. Given their association with mortality, these biomarkers merit further investigation of their underlying pathways, particularly in conjugation with the established biomarker NT-proBNP, to clarify their potential for more targeted clinical applications.
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