Gut-inflammation-SPARC axis associates with mobility decline in congestive heart failure

Area of Science:

• Cardiology
• Biomarkers
• Functional Mobility

Background:

• Impaired gait speed (GS) is a key predictor of poor outcomes in congestive heart failure (CHF).
• Molecular factors contributing to functional decline in CHF are not well understood, particularly those involving multisystem effects.
• Current research often overlooks non-cardiac biomarkers for mobility impairment.

Purpose of the Study:

• To investigate plasma osteonectin (OSN) as a novel biomarker for impaired gait speed (GS) in patients with congestive heart failure (CHF).
• To explore the relationship between OSN, gut permeability (zonulin), systemic inflammation (CRP), and GS in CHF.
• To assess the diagnostic accuracy of OSN for identifying poor functional performance in CHF.

Main Methods:

• Assessed cardiac function (LVEF), GS, and plasma levels of OSN, zonulin, and CRP in 286 CHF patients.
• Utilized multivariable adjusted analysis to determine independent relationships between biomarkers and GS.
• Employed ROC curve analysis to evaluate the diagnostic accuracy of OSN for poor GS.

Main Results:

• CHF patients had elevated OSN, zonulin, and CRP, all inversely correlated with GS (p < 0.0001).
• A significant independent dose-response relationship was found: decreased GS correlated with increased OSN.
• OSN demonstrated high diagnostic accuracy (AUC = 0.822) for identifying poor functional performance.

Conclusions:

• Plasma OSN is an independent biomarker associated with functional impairment and reduced gait speed in CHF patients.
• Findings suggest a link between gut barrier dysfunction, inflammation, and OSN in the context of mobility loss.
• OSN is a promising candidate for risk stratification and potential therapeutic intervention to improve mobility in CHF.