title: Heart failure biomarkers in patients with dilated cardiomyopathy.
abstract: BACKGROUND
  We set out to evaluate the utility of selected heart failure (HF) biomarkers in patients with dilated cardiomyopathy (DCM).
  
  
  METHODS
  In a prospective, randomized study, 68 DCM patients with left ventricular ejection fraction (LVEF) ≤ 40% treated optimally were included. They were observed for 5 years. Initial and control tests included full clinical examination, measurement of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and IL-10, syndecan-4, cystatin C (CysC) and N-terminal pro-brain natriuretic peptide (NT-proBNP), echocardiographic examination, and the assessment of exercise capacity in 6-minute walk test (6MWT).
  
  
  RESULTS
  Finally, after 5-year follow-up we analyzed the data of 45 DCM patients. Concentration of syndecan-4 correlated negatively with LVEF (R=-0.36, p=0.02) and positively with LV systolic (R=0.57, p<0.001) and diastolic diameters (R=0.64, p<0.001). A positive correlation between CysC and right ventricular diastolic diameter (R=0.38, p=0.01), and negative correlations between CysC and glomerular filtration rate (R=-0.49, p<0.001), LVEF (R=-0.4, p=0.02), and 6 MWT (R=-0.46, p<0.001) were noted. Patients who had an increase in LVEF during 5 years were characterized by lower levels of CysC (p=0.01) and NT-proBNP (p<0.001). CysC≤95mg/l and NT-proBNP≤32pg/ml were the best predictors of LVEF increase in DCM patients. Multivariate regression analysis showed that 6 MWT was the only independent predictor of HF re-hospitalization (OR 0.989; p<0.001), and NT-proBNP and LV diastolic diameter were the only risk factors of increased mortality (OR 1.001; p=0.007 and OR 2.960; p=0.025, respectively) in DCM patients.
  
  
  CONCLUSIONS
  CysC correlates negatively with both kidney function and exercise capacity. Syndecan-4 may be a useful biomarker for predicting adverse LV remodeling in DCM patients.
authors: Department of Hypertension, Medical University of Lodz, Poland.
authors: Agata
authors: A
authors: Bielecka-Dabrowa
authors: Stephan
authors: S
authors: von Haehling
authors: Wilbert S
authors: WS
authors: Aronow
authors: Mustafa I
authors: MI
authors: Ahmed
authors: Jacek
authors: J
authors: Rysz
authors: Maciej
authors: M
authors: Banach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000150:complications*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Dilated cardiomyopathy; Heart failure; Therapy