Abstract
Improvement of risk scoring is particularly important for patients with preserved left ventricular ejection fraction (LVEF) who generally lack efficient monitoring of progressing heart failure. Here, we evaluated whether the combination of serum biomarkers and echocardiographic parameters may be useful to predict the remodeling-related outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and preserved LVEF (HFpEF) as compared to those with reduced LVEF (HFrEF). Echocardiographic assessment and measurement of the serum levels of NT-proBNP, sST2, galectin-3, matrix metalloproteinases, and their inhibitors (MMP-1, MMP-2, MMP-3, TIMP-1) was performed at the time of admission (1st day) and on the 10th–12th day upon STEMI onset. We found a reduction in NT-proBNP, sST2, galectin-3, and TIMP-1 in both patient categories from hospital admission to the discharge, as well as numerous correlations between the indicated biomarkers and echocardiographic parameters, testifying to the ongoing ventricular remodeling. In patients with HFpEF, NT-proBNP, sST2, galectin-3, and MMP-3 correlated with the parameters reflecting the diastolic dysfunction, while in patients with HFrEF, these markers were mainly associated with LVEF and left ventricular end-systolic volume/diameter. Therefore, the combination of the mentioned serum biomarkers and echocardiographic parameters might be useful for the prediction of adverse cardiac remodeling in patients with HFpEF.
Highlights
Despite cardiovascular mortality trending to decline worldwide in the recent decade [1], it is still unacceptably high in Russian Federation [2,3]
Promising serum markers of ventricular remodeling include N-terminal pro-B-type natriuretic peptide (NT-proBNP, a protein released from cardiomyocytes at myocardial stretch), soluble suppression of tumorigenicity 2, galectin-3, matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) regulating the profibrotic remodeling [7,8], and exosomes enriched by pro-fibrotic miRNA
We found an increase in serum galectin-3 at both time points, yet no significant correlations with echocardiographic parameters were detected excepting a positive correlation with myocardial performance (Tei) index on the first day after segment elevation myocardial infarction (STEMI) onset
Summary
Despite cardiovascular mortality trending to decline worldwide in the recent decade [1], it is still unacceptably high in Russian Federation [2,3]. Advances in the diagnosis and treatment of coronary artery disease (CAD), ST-segment elevation myocardial infarction (STEMI), considerably reduced in-hospital but not long-term mortality rates, even in patients with preserved (≥50%) left ventricular ejection fraction (LVEF) [4]. Diagnostics of ventricular remodeling requires sensitive and specific biomarkers, which should be detectable in the serum, permitting noninvasive sample collection [7]. Promising serum markers of ventricular remodeling include N-terminal pro-B-type natriuretic peptide (NT-proBNP, a protein released from cardiomyocytes at myocardial stretch), soluble suppression of tumorigenicity 2 (sST2, a cytokine-related protein and an established marker of inflammation, hemodynamic stress, and cardiomyocytes strain), galectin-3 (an inflammatory β-galactoside-binding lectin acting as a matricellular protein), matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) regulating the profibrotic remodeling [7,8], and exosomes enriched by pro-fibrotic miRNA (miR-1, -21, -34a, -133, -192, -194, -208a, -425, -744) [9], none of them have been recommended for the specific assessment of ventricular remodeling progression so far [8]. The search for novel systemic markers of ventricular remodeling is ongoing, and various patient cohorts are involved
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
