title: Hepatocyte growth factor is a strong predictor of mortality in patients with advanced heart failure.
abstract: OBJECTIVE
  To assess the prognostic value of the mitogenic, antiapoptotic, angiogenic and antifibrotic hepatocyte growth factor (HGF) in heart failure (HF).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Assessment of HGF levels at inclusion in 351 patients with advanced HF (median 75 years, interquartile range (IQR) 63-82, 66% male).
  
  
  METHODS
  All-cause mortality, cardiovascular mortality.
  
  
  RESULTS
  During a median follow-up of 16&emsp14;months, 26% of patients died. HGF tertiles were associated with an increasing risk for all-cause mortality (p < 0.001) with a hazard ratio (HR) of 3.06 (95% confidence interval (CI) 1.69 to 5.53) for the third compared with the first tertile. This association remained significant after multivariable adjustment for B-type natriuretic peptide (BNP) and other risk factors (p = 0.002). Subgroup analysis revealed that HGF was a strong predictor of the secondary end point cardiovascular mortality in ischaemic HF (p = 0.009) with an adjusted HR of 6.2 (95% CI 1.76 to 21.8) comparing the third with the first tertile but not in non-ischaemic HF (HR = 1.47, 95% CI 0.48 to 4.49, p = 0.5). Patients with high HGF but low BNP had a comparable survival rate to those with elevated BNP but low HGF (p=0.66). Of note, the dose of angiotensin converting enzyme (ACE) inhibitors inversely correlated with HGF concentrations (r = -0.25, p < 0.001).
  
  
  CONCLUSIONS
  HGF is a strong and independent predictor of mortality in advanced HF and, in particular, in ischaemic HF. These results indicate that HGF with its multiple effects on myocardial function exerts an overall deleterious effect in advanced HF. HGF may be of special interest for risk prediction and tailoring of HF treatment.
authors.affiliation: Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Rychli
authors.forename: Bernhard
authors.initials: B
authors.lastname: Richter
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Hohensinner
authors.forename: Ali
authors.initials: A
authors.lastname: Kariem Mahdy
authors.forename: Stephanie
authors.initials: S
authors.lastname: Neuhold
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Zorn
authors.forename: Rudolf
authors.initials: R
authors.lastname: Berger
authors.forename: Deddo
authors.initials: D
authors.lastname: Mörtl
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Richard
authors.initials: R
authors.lastname: Pacher
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Alexander
authors.initials: A
authors.lastname: Niessner
authors.forename: Martin
authors.initials: M
authors.lastname: Hülsmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C066855:HGF protein, human; D020097:Natriuretic Peptide, Brain; D017228:Hepatocyte Growth Factor