1. Endovascular shedding markers in patients with heart failure with reduced ejection fraction.
- Author
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Nijst, Petra, Cops, Jirka, Martens, Pieter, Swennen, Quirine, Dupont, Matthias, Tang, Wai Hong W., and Mullens, Wilfried
- Subjects
HEART failure ,VENTRICULAR ejection fraction ,GLYCOCALYX ,PATHOLOGICAL physiology ,HEALTH outcome assessment ,DIAGNOSIS - Abstract
Abstract: Background: Endothelial glycocalyx degradation has been associated with multiple pathophysiological processes in cardiovascular disease. Aims: To explore the role of glycocalyx shedding markers in pathophysiology of HFrEF. Methods: In 123 HFrEF patients, the concentration, prognostic value, and association of glycocalyx shedding markers with other disease processes were investigated. Results: Median HA levels and syndecan‐1 levels in HFrEF patients were, respectively, 29.4 (10.7;61.6) ng/mL and 48.5 (33.6;80.8) ng/mL. Overall, HA‐levels were significantly higher in HFrEF patients compared to healthy subjects, but only 31% of HFrEF patients had HA‐levels above the cutoff of normal. There was no significant difference among HFrEF patients and healthy subjects regarding syndecan‐1 levels. HFrEF patients with elevated HA‐levels had a significantly worse outcome (log rank = 0.01) which remained significant after correction for established risk factors (HR 2.53 (1.13‐5.69);
P = .024). There was no significant relation between levels of shedding markers and neurohumoral activation (PRA, serum aldosterone, NT‐proBNP), myocardial injury (HS‐trop), inflammation (CRP), or other baseline characteristics. Conclusions: The glycocalyx shedding marker HA is significantly elevated in a subgroup of HFrEF patients and an independent predictor for worse clinical outcome. Glycocalyx shedding might be an additional factor in the pathophysiology of HF which warrants further investigation. [ABSTRACT FROM AUTHOR]- Published
- 2018
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