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Postprandial variability of novel heart failure biomarkers in Fontan patients compared to healthy volunteers

Authors :
Jakob A. Hauser
Vivek Muthurangu
Bejal Pandya
Ina Michel-Behnke
Andrew M. Taylor
Svitlana Demyanets
Source :
International Journal of Cardiology Congenital Heart Disease, Vol 3, Iss , Pp 100127- (2021)
Publication Year :
2021
Publisher :
Elsevier, 2021.

Abstract

Background: Blood-based biomarkers reflecting different components of cardiovascular pathophysiology are now used increasingly in patients with Fontan circulation due to univentricular congenital heart disease. Feeding alters haemodynamics significantly and, thus, may affect biomarker levels. As the haemodynamic responses to a meal differ between Fontan patients and normal subjects, we hypothesised that biomarker kinetics may also vary between these populations. Methods: In 15 patients with Fontan physiology, and 15 matched healthy volunteers, 4 heart failure biomarkers were measured under fasting conditions, and 3 after additional timepoints over 2 h following ingestion of a standardised liquid meal. Changes in biomarker levels over time and the effect of Fontan physiology, sex and age were tested using repeated-measures mixed models. Results: Under fasting conditions, high-sensitivity C-reactive protein (hsCRP), mid-regional pro-adrenomedullin (MR-proADM) and C-terminal pro-endothelin-1 (CT-proET-1) were raised significantly in Fontan patients compared to controls. Postprandially, mid-regional pro-atrial natriuretic peptide (MR-proANP) decreased significantly in patients (max. mean decrease ∼7% after 120 min). Conversely, it increased in normal subjects (max. mean increase ∼8% after 60 min). The remaining biomarkers did not change significantly. Conclusions: The ingestion of food triggers contrary deflections of MR-proANP levels in patients with Fontan circulation compared to normal subjects. Therefore, this parameter should be assessed under fasting conditions in order to correct for postprandial variability.

Details

Language :
English
ISSN :
26666685
Volume :
3
Issue :
100127-
Database :
Directory of Open Access Journals
Journal :
International Journal of Cardiology Congenital Heart Disease
Publication Type :
Academic Journal
Accession number :
edsdoj.2d28efa71914b9ab3f5f00836ec156b
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ijcchd.2021.100127