Pentraxin 3 Is a New Inflammatory Marker Correlated With Left Ventricular Diastolic Dysfunction and Heart Failure With Normal Ejection Fraction

Abstract

Background: Pentraxin 3 (PTX3) is a novel inflammatory marker and a member of pentraxin superfamily including C-reactive protein (CRP). The relationship between inflammatory markers and HFNEF remains unclear. Methods: We measured peripheral blood levels of PTX3, high-sensitivity CRP (hsCRP), tumor necrosis factor-alpha, and interleukin-6 in 323 patients comprising 82 HFNEF, 70 heart failure (HF) with reduced EF, and 171 non-HF patients. Levels of PTX3 were also measured at the aortic root and the coronary sinus in 75 patients. Results: The levels of PTX3, tumor necrosis factor-alpha, and interleukin-6, but not hsCRP, were significantly higher in HFNEF patients than in non-HF patients. Multivariate logistic regression analysis identified only high levels of PTX3 as the independent inflammatory marker correlated with the presence of HFNEF in patients with normal left ventricular (LV) EF (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.11-1.98, p<0.01) and with the presence of left ventricular diastolic dysfunction (LVDD) in non-HF patients (OR: 1.23, 95%CI: 1.02-1.50, p<0.05). Levels of PTX3 at the coronary sinus were significantly higher than at the aortic root in HFNEF patients (p<0.05) and in non-HF patients with LVDD (p<0.01). Conclusions: Pentraxin 3 is significantly elevated in HFNEF patients and produced in the coronary circulation in patients with LVDD. Pentraxin 3 is an independent inflammatory marker correlated with the presence of LVDD and HFNEF.