Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF

Marianna Adamo; Matteo Pagnesi; Mattia Di Pasquale; Alice Ravera; Kenneth Dickstein; Leong L Ng; Stefan D Anker; John G Cleland; Gerasimos S Filippatos; Chim C Lang; Piotr Ponikowski; Nilesh J Samani; Faiez Zannad; Dirk J van Veldhuisen; Erik Lipsic; Adriaan Voors; Marco Metra

doi:10.1016/j.ijcard.2023.131664

Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF

Marianna Adamo (Lead / Corresponding author), Matteo Pagnesi, Mattia Di Pasquale, Alice Ravera, Kenneth Dickstein, Leong L Ng, Stefan D Anker, John G Cleland, Gerasimos S Filippatos, Chim C Lang, Piotr Ponikowski, Nilesh J Samani, Faiez Zannad, Dirk J van Veldhuisen, Erik Lipsic, Adriaan Voors, Marco Metra

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Mitral regurgitation (MR) frequently coexists with heart failure (HF).

OBJECTIVES: To better understand potential pathophysiological differences between patients with HF with or without moderate-severe MR, we compared differentially expressed circulating biomarkers between these two groups.

METHODS: The Olink Proteomics® Multiplex Cardiovascular (CVD) -II, CVD-III, Immune Response and Oncology-II panels of 363 unique proteins from different pathophysiological domains were used to investigate the biomarker profiles of HF patients from index and validation cohorts of the BIOSTAT-CHF study stratified according to the presence of moderate-to-severe MR or no-mild MR.

RESULTS: The index cohort included 888 patients (46%) with moderate-to-severe MR and 1029 (54%) with no-mild MR at baseline. The validation cohort included 522 patients (33%) with moderate-to-severe MR and 1076 (66%) with no-mild MR at baseline. Compared to patients with no-mild MR, those with moderate-to-severe MR had lower body mass index, higher comorbidity burden, signs and symptoms of more severe HF, lower systolic blood pressure, and larger left atrial and ventricular dimensions, in both cohorts. NT-proBNP, CA125, fibroblast growth factor 23 (FGF23) and growth hormone 1 (GH1) were up-regulated, whereas leptin (LEP) was down-regulated in patients with moderate-severe MR versus no-mild MR, in both index and validation cohorts.

CONCLUSION: Circulating biomarkers differently expressed in HF patients with moderate-severe MR versus no-mild MR were related to congestion, lipid and mineral metabolism and oxidative stress. These findings may be of value for the development of novel treatment targets in HF patients with MR.

Original language	English
Article number	131664
Number of pages	9
Journal	International Journal of Cardiology
Volume	399
Early online date	21 Dec 2023
DOIs	https://doi.org/10.1016/j.ijcard.2023.131664
Publication status	Published - 15 Mar 2024

Keywords

Biomarkers
Heart failure
Mitral regurgitation

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.ijcard.2023.131664

Cite this

Adamo, M., Pagnesi, M., Di Pasquale, M., Ravera, A., Dickstein, K., Ng, L. L., Anker, S. D., Cleland, J. G., Filippatos, G. S., Lang, C. C., Ponikowski, P., Samani, N. J., Zannad, F., van Veldhuisen, D. J., Lipsic, E., Voors, A., & Metra, M. (2024). Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF. International Journal of Cardiology, 399, Article 131664. https://doi.org/10.1016/j.ijcard.2023.131664

@article{ba4226f6bbc74125b65159be900c01ab,

title = "Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF",

abstract = "BACKGROUND: Mitral regurgitation (MR) frequently coexists with heart failure (HF).OBJECTIVES: To better understand potential pathophysiological differences between patients with HF with or without moderate-severe MR, we compared differentially expressed circulating biomarkers between these two groups.METHODS: The Olink Proteomics{\textregistered} Multiplex Cardiovascular (CVD) -II, CVD-III, Immune Response and Oncology-II panels of 363 unique proteins from different pathophysiological domains were used to investigate the biomarker profiles of HF patients from index and validation cohorts of the BIOSTAT-CHF study stratified according to the presence of moderate-to-severe MR or no-mild MR.RESULTS: The index cohort included 888 patients (46%) with moderate-to-severe MR and 1029 (54%) with no-mild MR at baseline. The validation cohort included 522 patients (33%) with moderate-to-severe MR and 1076 (66%) with no-mild MR at baseline. Compared to patients with no-mild MR, those with moderate-to-severe MR had lower body mass index, higher comorbidity burden, signs and symptoms of more severe HF, lower systolic blood pressure, and larger left atrial and ventricular dimensions, in both cohorts. NT-proBNP, CA125, fibroblast growth factor 23 (FGF23) and growth hormone 1 (GH1) were up-regulated, whereas leptin (LEP) was down-regulated in patients with moderate-severe MR versus no-mild MR, in both index and validation cohorts.CONCLUSION: Circulating biomarkers differently expressed in HF patients with moderate-severe MR versus no-mild MR were related to congestion, lipid and mineral metabolism and oxidative stress. These findings may be of value for the development of novel treatment targets in HF patients with MR.",

keywords = "Biomarkers, Heart failure, Mitral regurgitation",

author = "Marianna Adamo and Matteo Pagnesi and {Di Pasquale}, Mattia and Alice Ravera and Kenneth Dickstein and Ng, {Leong L} and Anker, {Stefan D} and Cleland, {John G} and Filippatos, {Gerasimos S} and Lang, {Chim C} and Piotr Ponikowski and Samani, {Nilesh J} and Faiez Zannad and {van Veldhuisen}, {Dirk J} and Erik Lipsic and Adriaan Voors and Marco Metra",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

year = "2024",

month = mar,

day = "15",

doi = "10.1016/j.ijcard.2023.131664",

language = "English",

volume = "399",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier",

}

Adamo, M, Pagnesi, M, Di Pasquale, M, Ravera, A, Dickstein, K, Ng, LL, Anker, SD, Cleland, JG, Filippatos, GS, Lang, CC, Ponikowski, P, Samani, NJ, Zannad, F, van Veldhuisen, DJ, Lipsic, E, Voors, A & Metra, M 2024, 'Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF', International Journal of Cardiology, vol. 399, 131664. https://doi.org/10.1016/j.ijcard.2023.131664

TY - JOUR

T1 - Differential biomarker expression in heart failure patients with and without mitral regurgitation

T2 - Insights from BIOSTAT-CHF

AU - Adamo, Marianna

AU - Pagnesi, Matteo

AU - Di Pasquale, Mattia

AU - Ravera, Alice

AU - Dickstein, Kenneth

AU - Ng, Leong L

AU - Anker, Stefan D

AU - Cleland, John G

AU - Filippatos, Gerasimos S

AU - Lang, Chim C

AU - Ponikowski, Piotr

AU - Samani, Nilesh J

AU - Zannad, Faiez

AU - van Veldhuisen, Dirk J

AU - Lipsic, Erik

AU - Voors, Adriaan

AU - Metra, Marco

PY - 2024/3/15

Y1 - 2024/3/15

N2 - BACKGROUND: Mitral regurgitation (MR) frequently coexists with heart failure (HF).OBJECTIVES: To better understand potential pathophysiological differences between patients with HF with or without moderate-severe MR, we compared differentially expressed circulating biomarkers between these two groups.METHODS: The Olink Proteomics® Multiplex Cardiovascular (CVD) -II, CVD-III, Immune Response and Oncology-II panels of 363 unique proteins from different pathophysiological domains were used to investigate the biomarker profiles of HF patients from index and validation cohorts of the BIOSTAT-CHF study stratified according to the presence of moderate-to-severe MR or no-mild MR.RESULTS: The index cohort included 888 patients (46%) with moderate-to-severe MR and 1029 (54%) with no-mild MR at baseline. The validation cohort included 522 patients (33%) with moderate-to-severe MR and 1076 (66%) with no-mild MR at baseline. Compared to patients with no-mild MR, those with moderate-to-severe MR had lower body mass index, higher comorbidity burden, signs and symptoms of more severe HF, lower systolic blood pressure, and larger left atrial and ventricular dimensions, in both cohorts. NT-proBNP, CA125, fibroblast growth factor 23 (FGF23) and growth hormone 1 (GH1) were up-regulated, whereas leptin (LEP) was down-regulated in patients with moderate-severe MR versus no-mild MR, in both index and validation cohorts.CONCLUSION: Circulating biomarkers differently expressed in HF patients with moderate-severe MR versus no-mild MR were related to congestion, lipid and mineral metabolism and oxidative stress. These findings may be of value for the development of novel treatment targets in HF patients with MR.

AB - BACKGROUND: Mitral regurgitation (MR) frequently coexists with heart failure (HF).OBJECTIVES: To better understand potential pathophysiological differences between patients with HF with or without moderate-severe MR, we compared differentially expressed circulating biomarkers between these two groups.METHODS: The Olink Proteomics® Multiplex Cardiovascular (CVD) -II, CVD-III, Immune Response and Oncology-II panels of 363 unique proteins from different pathophysiological domains were used to investigate the biomarker profiles of HF patients from index and validation cohorts of the BIOSTAT-CHF study stratified according to the presence of moderate-to-severe MR or no-mild MR.RESULTS: The index cohort included 888 patients (46%) with moderate-to-severe MR and 1029 (54%) with no-mild MR at baseline. The validation cohort included 522 patients (33%) with moderate-to-severe MR and 1076 (66%) with no-mild MR at baseline. Compared to patients with no-mild MR, those with moderate-to-severe MR had lower body mass index, higher comorbidity burden, signs and symptoms of more severe HF, lower systolic blood pressure, and larger left atrial and ventricular dimensions, in both cohorts. NT-proBNP, CA125, fibroblast growth factor 23 (FGF23) and growth hormone 1 (GH1) were up-regulated, whereas leptin (LEP) was down-regulated in patients with moderate-severe MR versus no-mild MR, in both index and validation cohorts.CONCLUSION: Circulating biomarkers differently expressed in HF patients with moderate-severe MR versus no-mild MR were related to congestion, lipid and mineral metabolism and oxidative stress. These findings may be of value for the development of novel treatment targets in HF patients with MR.

KW - Biomarkers

KW - Heart failure

KW - Mitral regurgitation

U2 - 10.1016/j.ijcard.2023.131664

DO - 10.1016/j.ijcard.2023.131664

M3 - Article

C2 - 38141725

SN - 0167-5273

VL - 399

JO - International Journal of Cardiology

JF - International Journal of Cardiology

M1 - 131664

ER -

Differential biomarker expression in heart failure patients with and without mitral regurgitation: Insights from BIOSTAT-CHF

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