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08.09.2016 | Correspondence | Ausgabe 5-6/2016

Journal of Cardiovascular Translational Research 5-6/2016

Serial Echocardiographic Characteristics, Novel Biomarkers and Cachexia Development in Patients with Stable Chronic Heart Failure

Zeitschrift:
Journal of Cardiovascular Translational Research > Ausgabe 5-6/2016
Autoren:
Hanna K. Gaggin, Arianna M. Belcher, Parul U. Gandhi, Nasrien E. Ibrahim, James L. Januzzi Jr
Wichtige Hinweise
Associate Editor Daniel P. Judge oversaw the review of this article

Clinical Relevance

• While little is known regarding predictors of cachexia in heart failure patients, evaluation of serial echocardiography as well as novel and established biomarkers provided intriguing insight into the pathophysiology of cachexia in heart failure.
• Cachexia was common in heart failure patients with reduced ejection fraction and appeared to be closely associated with both baseline as well as serial measurement of amino-terminal pro-B type natriuretic peptide (NT-proBNP).

Abstract

Little is known regarding objective predictors of cachexia affecting patients with heart failure (HF). We studied 108 stable chronic systolic HF patients with serial echocardiography and biomarker measurements over 10 months. Cachexia was defined as weight loss ≥5 % from baseline or final BMI <20 kg/m2; 18.5 % developed cachexia. While there were no significant differences in baseline or serial echocardiographic measures in those developing cachexia, we found significant differences in baseline amino-terminal pro-B type natriuretic peptide (NT-proBNP), highly sensitive troponin I, sST2, and endothelin-1. Baseline log NT-proBNP (hazard ratio (HR) = 2.57, p = 0.004) and edema (HR = 3.36, p = 0.04) were predictive of cachexia in an adjusted analysis. When serial measurement of biomarkers was considered, only percent time with NT-proBNP ≥1000 pg/mL was predictive of cachexia. Thus, a close association exists between baseline and serial measurement of NT-proBNP and HF cachexia.

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