Abstract

Heart failure (HF) is a growing public health burden, with high prevalence and mortality rates. In contrast to ischemic heart failure (IHF), the diagnosis of non-ischemic heart failure (NIHF) is established in the absence of coronary artery disease. Angiopoietins (ANGPTs), vascular endothelial growth factors (VEGFs) and secretory phospholipases A2 (sPLA2s) are proinflammatory mediators and key regulators of endothelial cells. In the present manuscript, we analyze the plasma concentrations of angiogenic (ANGPT1, ANGPT2, VEGF-A) and lymphangiogenic (VEGF-C, VEGF-D) factors and the plasma activity of sPLA2 in patients with IHF and NIHF compared to healthy controls. The concentrations of ANGPT1, ANGPT2 and their ratio significantly differed between HF patients and healthy controls. Similarly, plasma levels of VEGF-D and sPLA2 activity were higher in HF as compared to controls. Concentrations of ANGPT2 and the ANGPT2/ANGPT1 ratio (an index of vascular permeability) were increased in NIHF patients. VEGF-A and VEGF-C concentrations did not differ among the three examined groups. Interestingly, VEGF-D was selectively increased in IFH patients compared to controls. Plasma activity of sPLA2 was increased in IHF and NIHF patients compared to controls. Our results indicate that several regulators of vascular permeability and smoldering inflammation are specifically altered in IHF and NIHF patients. Studies involving larger cohorts of these patients will be necessary to demonstrate the clinical implications of our findings.

Highlights

  • Heart failure (HF) represents a growing public health burden with an estimated prevalence in Europe and United States ranging from 0.4% to 2% [1]

  • ischemic heart failure (IHF) and Non-ischemic HF (NIHF) showed higher BNP levels and lower left ventricular ejection fraction (LVEF) compared to healthy controls (Table 1)

  • Contrariwise, no correlations were observed among the plasma concentrations of ANGPT1 and BNP, ANGPT2 and BNP, and Secreted or extracellular PLA2 (sPLA2) activity and BNP in NIHF patients

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Summary

Introduction

Heart failure (HF) represents a growing public health burden with an estimated prevalence in Europe and United States ranging from 0.4% to 2% [1]. Despite advances in management and therapies, the prognosis in HF patients remains poor, a deeper knowledge of the molecular mechanisms involved in the complex HF pathophysiology are needed for the identification of novel therapeutic targets and biomarkers to stratify prognosis and drive decision-making processes [6]. To this aim, several investigations have focused their attention on inflammatory and neurohormonal molecules

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