To access this material please log in or register

Register Authorize

Circulating factors associated with metabolic disorders in patients with post-infarction heart failure

Kochegura T. N.1, Makarevich P. I.1, Ovchinnikov A. G.2, Zhigunova L. V.2, Lakhova E. L.2, Masenko V. P.2, Parfenova E. V.2, Ageev F. T.2
1 - Federal State Budgetary Educational Institution of Higher Professional Education “M. V. Lomonosov Moscow State University”, Leninskie Gory 1, GSP-1, Moscow 119991
2 - Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: diagnostics, metabolic disorders, CHF

DOI: 10.18087/rhfj.2013.4.1863

Background. Data of epidemiological studies have shown that CHF remains one of the most severe, unresponsive and prognostically unfavorable complications of IHD. The cohort of IHD patients with concurrent metabolic disorders is understudied. Aim. Searching for new diagnostic markers and potential mechanisms of complicated CHF with concurrent metabolic disorders. Materials and methods. The study included 100 patients who were divided into 4 groups: 20 relatively healthy volunteers, 30 patients with post-infarction CHF, 24 CHF patients with concurrent type 2 DM (CHF+DM2) and 26 DM2 patients without CHF. The study protocol included a standard clinico-laboratory examination, measurement of circulating MR-proANP, NT-proBNP, adipokines, endothelin-1 (ET-1), angiogenic growth factors, and the proinflammatory cytokine, interleukin-6 (IL-6). Results. The level of cNT-proBNP was significantly higher in patients of the FC III CHF+DM2 group than in patients with FC III CHF without type 2 DM. Patients with CHF+DM2 had the highest level of cET-1, which was associated with LV diastolic dysfunction (DD). In patients with CHF+DM2. hyperleptinemia and hypoadiponectinemia were associated with obesity. The CHF+DM2 group had the highest level of cHGF, which depended on blood glucose control in type 2 DM. The highest levels of circulating resistin were observed in patients with CHF+DM2 and with DM2 without CHF. Increased levels of cIL-6 were found in patients with CHF and CHF+DM2. Conclusion. The prognostic value of cMR-proANP and cNT-proBNP can be assessed only in a prospective study. Levels of cET-1, cAN, cHM-AN, leptin, resistin, angiogenic growth factors cHGF, cVEGF, angiopoietin-1 and the proinflammatory cytokine IL-6 can be candidate markers associated with metabolic disorders in patients with post-infarction CHF, which should be tested in prospective studies.
  1. Шляхто Е., Красильникова Е., Винник Т. и др. Новые подходы к патогенетическому лечению метаболического сердечно-сосудистого синдрома. Врач. 2004;3:46–50.
  2. Беленков Ю. Н., Мареев В. Ю., Агеев Ф. Е. Хроническая сердечная недостаточность. Избранные лекции по кардиологии. –М.: «Гэотар-Медиа», 2006. –432 с.
  3. Cleland JG, Swedberg K, Cohen-Solal A et al. The Euro Heart Failure Survey of the EUROHEART survey programme. A survey on the quality of care among patients with heart failure in Europe. The Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The Medicines Evaluation Group Centre for Health Economics University of York. Eur J Heart Fail. 2000;2 (2):123–132.
  4. Lainscak M, Anker MS, von Haehling S et al. Biomarkers for chro­nic heart failure:diagnostic, prognostic, and therapeutic challenges. Herz. 2009;34 (8):589–593.
  5. Lainscak M., von Haehling S., Anker S. D. Natriuretic peptides and other biomarkers in chronic heart failure:from BNP, NT-proBNP, and MR-proANP to routine biochemical markers. Int J Cardiol. 2009;132 (3):303–311.
  6. Дедов И. И., Шестакова М. В. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. –М.:2011. –115с.
  7. Lainchbury JG, Troughton RW, Strangman KM et al. N-terminal pro-B-type natriuretic peptide-guided treatment for chronic heart failure: results from the BATTLESCARRED (NT-proBNP-Assisted Treatment To Lessen Serial Cardiac Readmissions and Death) trial. J Am Coll Cardiol. 2009;55 (1):53–60.
  8. van Hateren KJ, Alkhalaf A, Kleefstra N et al. Comparison of midregional pro-A-type natriuretic peptide and the N-terminal pro-B-type natriuretic peptide for predicting mortality and cardiovascular events. Clin Chem. 2012;58 (1):293–297.
  9. von Haehling S, Papassotiriou J, Hartmann O et al. Mid-regional pro-atrial natriuretic peptide as a prognostic marker for all-cause mortality in patients with symptomatic coronary artery disease. Clin Sci (Lond). 2012;123 (10):601–610.
  10. Maisel A, Mueller C, Nowak R et al. Mid-region pro-hormone markers for diagnosis and prognosis in acute dyspnea:results from the BACH (Biomarkers in Acute Heart Failure) trial. J Am Coll Cardiol. 2010;55 (19):2062–2076.
  11. von Haehling S, Jankowska EA, Morgenthaler NG et al. Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in predicting survival in patients with chronic heart failure. J Am Coll Cardiol. 2007;50 (20):1973–1980.
  12. Parker JD, Thiessen JJ. Increased endothelin-1 production in patients with chronic heart failure. Am J Physiol Heart Circ Physiol. 2004;286 (3):1141–1145.
  13. Kaoukis A, Deftereos S, Raisakis K et al. The role of endothelin system in cardiovascular disease and the potential therapeutic perspectives of its inhibition. Curr Top Med Chem. 2013;13 (2):95–114.
  14. Drawnel FM, Archer CR, Roderick HL. The role of the paracrine / autocrine mediator endothelin-1 in regulation of cardiac contractility and growth. Br J Pharmacol. 2013;168 (2):296–317.
  15. von Haehling S, Doehner W, Anker SD. Revisiting the obesity paradox in heart failure: new insights? Eur J Heart Fail. 2011;13 (2):130–132.
  16. von Haehling S, Horwich TB, Fonarow GC, Anker SD. Tipping the scale: heart failure, body mass index, and prognosis. Circulation. 2007;116 (6):588–590.
  17. Uslu S, Kebapçi N, Kara M, Bal C. Relationship between adipocytokines and cardiovascular risk factors in patients with type 2 diabetes mellitus. Exp Ther Med. 2012;4 (1):113–120.
  18. Mohga SA, Hayat MS, Ashraf IA et al. Association of serum Leptin and Adiponectin with Atherosclerosis in obese and non-obese Type 2 Diabetes Mellitus patients. Journal of American Science 2010;6 (5):153–164.
  19. Djoussé L, Wilk JB, Hanson NQ et al. Association between adiponectin and heart failure risk in the physicians' health study. Obesity (Silver Spring). 2013 Apr;21 (4):831–834.
  20. Kizer JR, Benkeser D, Arnold AM et al. Associations of total and high-molecular-weight adiponectin with all-cause and cardiovascular mortality in older persons:the Cardiovascular Health Study. Circulation. 2012;126 (25):2951–2961.
  21. Kunita E, Yamamoto H, Kitagawa T et al. Association between plasma high-molecular-weight adiponectin and coronary plaque characteristics assessed by computed tomography angiography in conditions of visceral adipose accumulation. Circ J. 2012;76 (7):1687–1696.
  22. Dale EA, Sheldon EL, Sweeney G. Cardiac Remodeling in Obesity. Physiol Rev. 2008;88 (2):389–419.
  23. Reilly MP, Iqbal N, Schutta M et al. Plasma leptin levels are associated with coronary atherosclerosis in type 2 diabetes. J Clin Endocrinol Metab. 2004;89 (8):3872–3878.
  24. Franks PW, Brage S, Luan J et al. Leptin predicts a worsening of the features of the metabolic syndrome independently of obesity.Obes Res. 2005;13 (8):1476–1484.
  25. Gjesdal O, Bluemke DA, Lima JA. Cardiac remodeling at the population level – risk factors, screening, and outcomes. Nat rev Cardiol. 2011;8 (12):673–685.
  26. Lee SE, Kim HS. Human resistin in cardiovascular disease. J Smooth Muscle Res. 2012;48 (1):27–35.
  27. Gürsoy G, Ulu S, Acar Y et al. Relation of resistın wıth obesity and some cardiovascular risk factors in hypertensive women. J Res Med Sci. 2012;17 (5):443–447.
  28. Choi EK, Kim HS, Park KW et al. Novel Index of Coronary Collateral Development as a Useful Predictor of Clinical Outcome in Type 2 Diabetic Patients With Coronary Artery Disease. Circ J 2005;69 (7):786–792.
  29. Silha JV, Krsek M, Sucharda P, Murphy LJ. Angiogenic factors are elevated in overweight and obese individuals. Int J Obes (Lond). 2005;29 (11):1308–1314.
  30. Satani K, Konya H, Hamaguchi T. et al. Clinical significance of circulating hepatocyte growth factor, a new risk marker of carotid atherosclerosis in patients with Type 2 diabetes. Diabet Med. 2006;23 (6):617–622.
  31. Hiratsuka A, Adachi H, Fujiura Y et al. Strong association between serum hepatocyte growth factor and metabolic syndrome. J Clin Endocrinol Metab. 2005;90 (5):2927–2931.
  32. Rychli K, Richter B, Hohensinner PJ et al. Hepatocyte growth factor is a strong predictor of mortality in patients with advanced heart failure. Heart. 2011;97 (14):1158–1163.
  33. Nian M, Lee P, Khaper N, Liu P. Inflammatory cytokines and postmyocardial infarction remodeling. Circ Res. 2004;94 (12):1543–553.
  34. Lim HS, Blann AD, Chong AY et al. Plasma vascular endothelial growth factor, angiopoietin-1, and angiopoietin-2 in diabetes:implications for cardiovascular risk and effects of multifactorial intervention. Diabetes Care. 2004;27 (12):2918–2924.
  35. Nanchen D, Stott DJ, Gussekloo J et al. Resting heart rate and incident heart failure and cardiovascular mortality in older adults:role of inflammation and endothelial dysfunction:the PROSPER study. Eur J Heart Fail. 2013;15 (5):581–588.
  36. Niethammer M, Sieber M, von Haehling S et al. Inflammatory pathways in patients with heart failure and preserved ejection fraction. Int J Cardiol. 2008;129 (1):111–117.
Kochegura T.N., Makarevich P.I., Ovchinnikov A.G. et al. Circulating factors associated with metabolic disorders in patients with post-infarction heart failure. Russian Heart Failure Journal. 2013;14 (4):191-199

To access this material please log in or register

Register Authorize
Ru En