Abstract
Background Heart failure (HF) is characterized by unfavorable prognosis. Disease trajectory of HF, however, may vary, and risk assessment of patients remains elusive. In our study, we sought to determine the prognostic impact of endocan—a novel biomarker of endothelial dysfunction and low-grade inflammation—in patients with heart failure. Methods In outpatients with chronic HF, baseline values of endocan were determined and clinical follow-up for a minimum of 18 months obtained. A multivariate Cox proportional hazard model was built for HF-related death or hospitalization requiring inotropic support. Results A total of 120 patients (mean age 71 years, 64% male, mean LVEF 36%) were included. During a mean follow-up of 656 ± 109 days, 50 patients (41.6%) experienced an event. On Cox multivariate analysis, endocan values emerged as an independent predictor of HF prognosis (HR, 1.471 CI 95% 1.183-1.829, p = 0.001, for each 1 ng/mL increase) even after adjustment for age, gender, HF etiology, LVEF, NYHA class, NT-proBNP, and exercise tolerance. Conclusions Endocan is an independent predictor of HF-related events in chronic HF individuals and represents a promising tool for risk assessment of HF patients.
Highlights
Heart failure is characterized by unfavorable prognosis [1,2,3]
Patients who experienced an event had significantly lower left ventricular ejection fraction (LVEF), lower exercise tolerance assessed by 6-minute walking test (6MWT), higher NT-proBNP, and higher New York Heart Association (NYHA) class; they significantly likely had ischemic etiology of Heart failure (HF)
Numerous studies have identified selected clinical parameters such as age, gender, HF etiology, LVEF, NYHA class, and NT-proBNP level as independent predictors of adverse HF prognosis [1, 2], considerable data suggests that objective measure of subclinical disease and pathophysiological derangements related to HF, such as neurohumoral activation, endothelial dysfunction, or low-grade inflammation, may provide estimation of morbidity and mortality risk beyond clinical parameters [4, 9, 12, 23,24,25]
Summary
Heart failure is characterized by unfavorable prognosis [1,2,3]. Patient populations, may differ strikingly in terms of etiology, pathophysiology, and natural disease progression [1, 3]. Identification of prognostic biomarkers to improve risk stratification of heart failure patients beyond traditional clinical predictors, such as etiology, left ventricular ejection fraction (LVEF), or. As unfavorable prognosis in heart failure is at least partially driven by endothelial dysfunction and low-grade inflammation, endocan represents a promising tool for detection of peripheral derangement and their prognostic impact in individuals with heart failure [4, 9,10,11,12]. We sought to determine the prognostic impact of endocan—a novel biomarker of endothelial dysfunction and low-grade inflammation—in patients with heart failure. Endocan is an independent predictor of HF-related events in chronic HF individuals and represents a promising tool for risk assessment of HF patients
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