title: Prognostic value of plasma ghrelin in predicting the outcome of patients with chronic heart failure.
abstract: OBJECTIVE
  Ghrelin is an endogenous ligand of the growth hormone (GH) secretagogue receptor and is closely associated with chronic heart failure (CHF). We undertook this study to investigate the relevance of ghrelin in CHF prognosis.
  
  
  METHODS
  A total of 145 in-patients with CHF in NYHA class II, III or IV despite optimized therapy were prospectively included in the study, grouped according to NYHA class and compared with 55 healthy control subjects. Ghrelin and N-terminal pro-B-type natriuretic peptide (Nt pro-BNP) were measured in plasma by ELISA. Echocardiographic information was also measured, including left atrial dimension, left ventricular end-diastolic diameter, LV volume and left ventricular ejection fraction (LVEF). Patients were followed for 2 years or until major adverse cardiac events.
  
  
  RESULTS
  Plasma ghrelin levels were significantly lower in patients with CHF than in control subjects (p = 0.014). In addition, plasma ghrelin levels differed significantly with the severity of CHF. Notably, survival analysis showed that high ghrelin levels were an indicator of a favorable prognosis for CHF. Our results also showed that ghrelin correlated inversely with plasma Nt pro-BNP levels (r = -0.562, p <0.001) and positively with LVEF (r = 0.620, p <0.001) in patients with CHF. Furthermore, multivariate analysis showed that ghrelin levels were independently associated with adverse cardiac events (hazard ratio: 0.72; 95% CI: 0.64-0.81, p = 0.03).
  
  
  CONCLUSIONS
  Ghrelin is a new biomarker of CHF severity as well as a new prognostic predictor for patients with CHF. Future experimental and clinical studies are warranted to evaluate ghrelin as a novel prognostic tool and for its therapeutic potential in patients with CHF.
authors: Department of Cardioangiology (South Area), Weifang People's Hospital, Weifang, Shandong, China.
authors: Yanbo
authors: Y
authors: Chen
authors: Department of Cardioangiology (South Area), Weifang People's Hospital, Weifang, Shandong, China.
authors: Xiang-wu
authors: XW
authors: Ji
authors: Department of Cardioangiology (South Area), Weifang People's Hospital, Weifang, Shandong, China. Electronic address: 449200264@qq.com.
authors: Ai-yuan
authors: AY
authors: Zhang
authors: Public Health Department of Weifang Medical University, Weifang, Shandong, China.
authors: Jun-cheng
authors: JC
authors: Lv
authors: Department of Cardioangiology (South Area), Weifang People's Hospital, Weifang, Shandong, China.
authors: Jun-gang
authors: JG
authors: Zhang
authors: Department of Cardioangiology (South Area), Weifang People's Hospital, Weifang, Shandong, China.
authors: Chun-hua
authors: CH
authors: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D014463:Ultrasonography; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D054439:Ghrelin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Cardiovascular active peptide; Chronic heart failure; Ghrelin; Prognosis