Association of Plasma Renalase and Left Ventricle Mass Index in Heart Failure Patients Stratified to the Category of the Ejection Fraction: A Pilot Study.

Dijana Stojanovic,Miodrag Stojanovic,Nikola Stefanovic,Dejan Petrovic,Aleksandra Ignjatovic,Gordana Kocic,Valentina Mitic,Marina Deljanin Ilic,Vladmila Bojanic,Tatjana Cvetkovic

doi:10.1155/2019/7265160

Dijana Stojanovic, Miodrag Stojanovic + Show 8 more

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https://doi.org/10.1155/2019/7265160

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Abstract

Heart failure represents a growing health problem, with increasing morbidity and mortality globally. According to the mechanisms involved in the pathogenesis of heart failure, many biomarkers have been proposed for the timely diagnosis and prognostication of patients with heart failure, but other than natriuretic peptides, none of them has gained enough clinical significance. Renalase, a new protein derived from kidneys was demonstrated to metabolize catecholamines and to have a cardioprotective role. The aim of the study was to determine whether renalase and brain natriuretic peptide (BNP) concentration could be used to differentiate heart failure patients stratified to the category of the ejection fraction and whether plasma renalase could be used as a biomarker for left ventricle hypertrophy in all subgroups of heart failure patients. We included patients diagnosed with heart failure and stratified them to the three subgroups according to the ejection fraction. Regarding echocardiographic parameters, HFmrEF had an intermediate profile in between HFrEF and HFpEF, with statistical significance in most evaluated parameters. BNP concentration was significantly different in all three subgroups (p < 0.001), and renalase was statistically higher in HFrEF (p = 0.007) compared to the HFmrEF and HFpEF, where its results were similar, without statistical significance. Renalase plasma concentration was demonstrated to be highly and positively associated with left ventricle mass index in HFrEF (p = 0.029), as well as increased plasma concentration of BNP (p = 0.006). In the HFmrEF group of patients, body mass index was positively associated with LVMI (p = 0.05), while in the patients with HFpEF, diabetes mellitus was demonstrated to have a positive association with LVMI (p = 0.043). These findings suggest that renalase concentration may be measured in order to differentiate patients with reduced ejection fraction. Plasma renalase concentrations positively correlated with left ventricle hypertrophy in patients with reduced ejection fraction, being strongly associated with increased left ventricular mass index.

Highlights

Heart failure (HF) represents a response to a previous cardiovascular injury presented with an abnormal cardiac structure or function, leading to increased intracardiac pressures or a decreased cardiac output [1], with increasing morbidity and mortality globally [2]
The aim of the study was to determine whether renalase and brain natriuretic peptide (BNP) concentration could be used to differentiate heart failure patients stratified to the category of the ejection fraction and whether plasma renalase could be used as a biomarker for left ventricle hypertrophy in all subgroups of heart failure patients
Hypothesizing that renalase may reflect sympathetic activity, exerting cytokine properties, the aims of the study were to determine firstly whether renalase and brain natriuretic peptide (BNP) concentration could be used to differentiate heart failure patients stratified to the category of the ejection fraction and secondly whether plasma renalase could be used as a biomarker for left ventricle hypertrophy in all subgroups of heart failure patients

Summary

Introduction

Heart failure (HF) represents a response to a previous cardiovascular injury presented with an abnormal cardiac structure or function, leading to increased intracardiac pressures or a decreased cardiac output [1], with increasing morbidity and mortality globally [2]. The activation of the SNS is able to preserve organ perfusion for a short time, but in the long term, it may lead to catecholamine-induced cardiotoxicity, resulting in reduced EF [4], while cytokine overproduction makes this a predictor of a worse outcome [5]. In order to test the hypothesis that the kidney has an important role in preserving cardiovascular health, a new protein, subsequently called renalase, was discovered in 2005 [7], predominantly expressed in proximal tubules and to a lesser extent in the heart, liver, and skeletal muscles [7], after subtotal nephrectomy experiments in neonatal and adult rats showed that they develop left ventricular hypertrophy [7]. It was concluded that extracellular renalase may have cytokine properties [13], promoting cell survival

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