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Updated: Jul 3, 2026
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Analysis of Epididymal Protein Synthesis and Secretion
Published on: August 25, 2018
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High Human Epididymis Protein 4 Levels Are Associated With Lower Systolic Function and Poor Prognosis in Heart
Yuki Okuno1, Shinsuke Hanatani1, Fumihiko Ogata1
1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
Summary
Human epididymis protein 4 (HE4) is a significant independent prognostic biomarker in heart failure with reduced ejection fraction (HFrEF). Higher HE4 levels predict adverse cardiovascular events and hospitalization, especially when combined with reduced global longitudinal strain.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Human epididymis protein 4 (HE4) is a fibrosis marker.
- Previous studies showed HE4's prognostic value in dilated cardiomyopathy.
- HE4's role in general heart failure with reduced ejection fraction (HFrEF) was unclear.
Purpose of the Study:
- To investigate the prognostic significance of HE4 in patients with HFrEF.
- To determine the association of HE4 with cardiovascular outcomes and other clinical parameters.
Main Methods:
- Serum HE4 concentrations were measured in 140 HFrEF patients.
- Patients were followed for up to 3 years for cardiovascular death and heart failure hospitalization.
- Statistical analyses included Kaplan-Meier, Cox regression, and linear regression.
Main Results:
- Higher serum HE4 levels were associated with significantly increased rates of cardiovascular events.
- HE4 was identified as an independent predictor of adverse outcomes in HFrEF.
- HE4 correlated with age, creatinine, B-type natriuretic peptide, E/e', and global longitudinal strain (GLS).
- Combining high HE4 and low GLS identified patients with the highest cardiovascular event rates.
Conclusions:
- HE4 is an independent prognostic biomarker in HFrEF.
- The association between HE4 and GLS may indicate myocardial dysfunction and fibrosis.
- These findings suggest HE4's utility in risk stratification for HFrEF patients.
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