Abstract

Introduction: Coronary disease is the most common cause of heart failure (HF). HF is classified as ischemic (IHF) or non-ischemic (NIHF) based on this etiology. IHF and NIHF have distinct mechanisms not accounted for by ejection fraction (EF) and an improved understanding of the differences could drive the discovery of novel therapeutic targets. We therefore sought to identify proteomic signatures between IHF and NIHF. Methods: Proteomic profiling using the SomaScan®1.7K was performed using plasma samples from HF patients in a community cohort (Rochester Epidemiology Project, 2003-2012). IHF was defined by prior myocardial infarction, percutaneous coronary intervention or coronary artery bypass graft, or obstructive disease in at least 1 vessel on coronary angiography. We compared the protein expression levels between IHF and NIHF using t-test and applied the Benjamini-Hochberg false-discovery rate (FDR) procedure for multiple comparisons. We explored pathway analysis for functional annotations using the biological process component of the Gene Ontology Resource (Panther 17v). Results: Among 1,388 patients, there were 518 IHF patients (age: 75±12years, 39.4% female, NYHA Class III/IV: 72.5%, EF:45±15%), and 870 NIHF patients (age: 75±14years, 53.6% female, NYHA Class III/IV: 66.9%, EF:49±17%). Among 7335 plasma proteins quantified, 63 unique proteins (FDR < 0.05) were differentially expressed between IHF and NIHF. Thirty-seven proteins including Troponin-I and T, and Myoglobin showed increased expression in IHF compared to NIHF and 26 including IGFBP-3 showed decreased expression. Pathophysiologic pathways including angiogenesis, coagulation, and lipid metabolism were represented in IHF, while inflammation and remodeling signaling pathways were dominant in relation to NIHF. Conclusions: High-throughput proteomic techniques are able to delineate IHF versus NIHF patients based on distinct biomarkers and pathophysiologic processes.

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