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The partnership between renalase and ejection fraction as a risk factor for increased cardiac remodeling biomarkers in chronic heart failure patients
Authors:Dijana Stojanovic  Valentina Mitic  Miodrag Stojanovic  Dejan Petrovic  Aleksandra Ignjatovic  Nikola Stefanovic
Affiliation:1. Faculty of Medicine, Institute of Pathophysiology, University of Nis, Nis, Serbia;2. dijanam24@hotmail.com;4. Institute for Treatment and Rehabilitation “Niska Banja”, Ni?ka Banja, Serbia;5. Department of Medical Statistics and Informatics, Faculty of Medicine, University of Nis, Nis, Serbia;6. Institute for Public Health, Nis, Serbia;7. Department of Internal Medicine, Faculty of Medicine, University of Nis, Nis, Serbia;8. Department of Pharmacy, Faculty of Medicine, University of Nis, Nis, Serbia
Abstract:
Abstract

Objective: Heart failure (HF) represents a huge socio-economic burden. It has been demonstrated, experimentally, that renalase, a newly discovered protein, prevents cardiac hypertrophy and adverse remodeling, which is seen in HF. We postulated the following aims: to investigate associations of renalase with biomarkers of cardiac remodeling: galectin-3, soluble suppression of tumorigenicity, (sST2), growth differentiation factor 15 (GDF-15) and syndecan-1, myocardial stretch (BNP) and cardio-renal axis (cystatin C) in HF patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) to determine whether renalase, in combination with left ventricular ejection fraction (LVEF), represents a risk factor for plasma elevation in biomarkers.

Methods: We classified HF patients (n?=?76) according to LVEF (preserved/reduced), applied a median plasma renalase (113?ng/mL) as a cut-off value (low/high) and created four subgroups of HF patients: HFpEF/low renalase (n?=?19), HFrEF/low renalase (n?=?19), HFrEF/high renalase (n?=?32) and HFpEF/high renalase (n?=?6). A control group (n?=?35) consisted of healthy volunteers.

Results: Plasma concentrations of evaluated biomarkers were determined using an ELISA technique and were highest in HF patients with reduced EF (p?r?=?0.913; p?r?=?0.965; p?r?=?0.887; p?r?=?0.922; p?r?=?0.527; p?r?=?0.844; p?r?=??0.456, p?p?p?Conclusion: When elevated plasma renalase and HF are present, regardless of EF being reduced or preserved, that represents a significant risk factor for increase in cardiac remodeling biomarker plasma concentrations. However, only elevated renalase and reduced EF demonstrated significance as a risk factor for BNP and cystatin C plasma elevation. Renalase may be considered a promising molecule for the improved predictive abilities of conventional biomarkers and is worthy of further investigation.
Keywords:Renalase  cardiac remodeling biomarkers  BNP  heart failure  EF
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