Associations among Biomarkers of Congestion, Inflammation and Oxidative Stress in Heart Failure, LVAD and Heart Transplant

Abstract

Purpose Biomarkers of congestion, inflammation and oxidative stress are increased in HF, LVAD and heart transplant (HT) pts, and are associated with poor outcomes. However, the relation between biomarkers belonging to specific pathways remains understudied. We sought to investigate these relationships across a broad spectrum of HF stages and treatments. Methods Markers of congestion (proBNP), inflammation (sCD14, CRP, interleukin-6 (IL6), tumor necrosis factor-α (TNFα), endothelin-1 (ET1), adiponectin (A) and TMAO) and oxidative stress (isoprostane (I)) were concurrently collected and measured in 4,997 blood samples among 669 pts (age = 57±13 y, 83% male, 192 HF, 232 LVAD and 245 HT). Biomarkers were normalized via log-transformation prior to analysis. Results Biomarker levels by disease category are shown in the table. In correlation analysis across all categories, we found a strong association between IL6 and CRP (overall r=0.77, HF r=0.76, LVAD r=0.79, HT r=0.72; all p Conclusion Markers of congestion, inflammation and oxidative stress are linked across a broad spectrum of HF progression and treatment stages suggesting a complex crosstalk between biological pathways. Futures longitudinal studies are necessary to determine temporality and mechanisms of these correlations.