The partnership between renalase and ejection fraction as a risk factor for increased cardiac remodeling biomarkers in chronic heart failure patients |
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Authors: | Dijana Stojanovic Valentina Mitic Miodrag Stojanovic Dejan Petrovic Aleksandra Ignjatovic Nikola Stefanovic |
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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 |
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Abstract: | AbstractObjective: 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?.001, respectively), and renalase’s positive correlations were obtained relating to all biomarkers: galectin-3 (r?=?0.913; p?.001), sST2 (r?=?0.965; p?.001), GDF-15 (r?=?0.887; p?.001), syndecan-1 (r?=?0.922; p?.001), BNP (r?=?0.527; p?.001) and cystatin C (r?=?0.844; p?.001) and strong and negative correlation with LVEF (r?=??0.456, p?.001). Increased renalase, regardless of the EF (preserved/reduced), was shown to be an independent risk factor for an increase in all evaluated cardiac remodeling biomarkers, p?.001, respectively. However, increased renalase and reduced EF was the only independent risk factor for BNP and cystatin C elevation, p?.001, respectively. Results after multivariable adjustments (age/gender) were identical.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. |
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Keywords: | Renalase cardiac remodeling biomarkers BNP heart failure EF |
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