Abstract
Background: Heart failure (HF) is a multifactorial syndrome with pathophysiological complexities still not fully understood. Higher mean platelet volume (MPV), a potential marker of platelet activation, and high concentrations of parathyroid hormone (PTH) have been implicated in the pathogenesis of HF.Aim: This study aims to investigate sex-specifically the association between PTH concentrations and platelet indices in phenotypes of HF.Methods and Results: PTH and platelet indices (MPV and platelet count) were available in 1,896 participants from the MyoVasc study in Mainz, Germany. Multivariable linear regression models, adjusted for age, sex, season, vitamin D status, cardiovascular risk factors, comorbidities, estimated glomerular filtration rate, and medication, were used to assess the associations between platelet indices and PTH. The results showed distinct sex-specific associations between PTH and platelet indices. A positive association between PTH and MPV was found in females with symptomatic HF with reduced ejection fraction (HFrEF) only [β = 0.60 (0.19; 1.00)]. Platelet count was inversely associated with PTH in male HFrEF individuals [β = −7.6 (−15; −0.30)] and in both males and females with HF with preserved ejection fraction (HFpEF).Conclusion: This study reports differential, sex-specific relationships between PTH and platelet indices in HF individuals independent of vitamin D status and clinical profile. Particularly in phenotypes of symptomatic HF, distinct associations were observed, suggesting a sex-specific mechanism involved in the interaction between PTH and platelets.
Highlights
Heart failure (HF) is one of the most common cardiovascular diseases (CVDs) accounting for substantial morbidity and mortality worldwide, with increasing incidence and prevalence especially among the elderly [1]
More than 80% of individuals with reduced ejection fraction (EF) and HF with reduced ejection fraction (HFrEF) were males with a higher frequency of smokers, dyslipidemia, coronary artery disease, and history of myocardial infarction compared to individuals with preserved EF and HF with preserved ejection fraction (HFpEF), respectively
Individuals with preserved EF and HFpEF had more often arterial hypertension and a history of venous thromboembolism (VTE) compared to Preserved EF (N = 1,197)
Summary
Heart failure (HF) is one of the most common cardiovascular diseases (CVDs) accounting for substantial morbidity and mortality worldwide, with increasing incidence and prevalence especially among the elderly [1]. Elevated parathyroid hormone (PTH) concentrations have been associated with all-cause and cardiovascular mortality in HF patients, suggesting a potential role for PTH in the pathogenesis and progression of HF [4, 5]. PTH is physiologically released at low calcium concentrations to stimulate the synthesis of the active form of vitamin D, Calcitriol, which in turn suppresses PTH release as a negative feedback regulation of calcium homeostasis [6]. Heart failure (HF) is a multifactorial syndrome with pathophysiological complexities still not fully understood. Higher mean platelet volume (MPV), a potential marker of platelet activation, and high concentrations of parathyroid hormone (PTH) have been implicated in the pathogenesis of HF
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