title: Soluble Fms-like tyrosine kinase 1 is a novel predictor of brain natriuretic peptide elevation.
abstract: Soluble fms-like tyrosine kinase 1 (sFlt-1) is an endogenous inhibitor of vascular endothelial growth factor, which is involved in cardiovascular remodeling and atherosclerosis development. To examine the predictive role of sFlt-1 levels in patients with asymptomatic heart failure, we measured circulating sFlt-1 in patients with or without coronary artery disease (CAD). We analyzed 88 Japanese patients with CAD or patients at high risk for atherosclerosis and who were undergoing total risk management for cardiovascular disease prevention. Circulating sFlt-1 levels correlated with the increase in plasma brain natriuretic peptide levels (ΔBNP) from baseline to the observed levels 5 years later in CAD patients, patients with previous myocardial infarction, and men. ΔBNP levels correlated with sFlt-1 levels in the high-sFlt-1 patients with CAD (r = 0.511, P < 0.01). In all patients, end-systolic volume index (ΔESVI) increased in correlation with a decrease in left ventricular ejection fraction (ΔEF) in the long-term observation, independent of their history of myocardial infarction (ΔESVI = 2.5 mL/m(2) increase/year). Baseline level of sFlt-1 was independent of ΔESVI or ΔEF. The present 5-year observational study demonstrated that high sFlt-1 levels predicted moderate increases in BNP levels in CAD patients. Moreover, ΔBNP was correlated with ΔESVI/year in CAD patients with high-sFlt-1 levels. These data suggest that high sFlt-1 levels may be an effective biomarker to predict the progression of heart failure in patients with CAD.
authors.affiliation: Kitasato University Graduate School of Medical Sciences, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kameda
authors.forename: Minako
authors.initials: M
authors.lastname: Yamaoka-Tojo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Makino
authors.forename: Kazuki
authors.initials: K
authors.lastname: Wakaume
authors.forename: Shinji
authors.initials: S
authors.lastname: Nemoto
authors.forename: Lisa
authors.initials: L
authors.lastname: Kitasato
authors.forename: Takao
authors.initials: T
authors.lastname: Shimohama
authors.forename: Taiki
authors.initials: T
authors.lastname: Tojo
authors.forename: Yoji
authors.initials: Y
authors.lastname: Machida
authors.forename: Tohru
authors.initials: T
authors.lastname: Izumi
mesh_terms: D000368:Aged; D044466:Asian People; D050197:Atherosclerosis / Q000097:blood* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D040281:Vascular Endothelial Growth Factor Receptor-1