title: CXCL16 is a novel diagnostic marker and predictor of mortality in inflammatory cardiomyopathy and heart failure.
abstract: BACKGROUND
  Cardiac inflammation has been suggested to play a critical role in the pathogenesis of inflammatory cardiomyopathy as well as in progressive heart failure (HF). CXC motif ligand 16 (CXCL16) is a recently discovered chemokine produced by several inflammatory cells and representing an important pathogenic mediator in the development of HF. The present study evaluates the diagnostic and prognostic relevance of CXCL16 expression in endomyocardial biopsies of consecutive patients with congestive HF.
  
  
  RESULTS
  174 patients (age 54.4±14.6 years) with congestive HF undergoing endomyocardial biopsy for diagnostic reasons were prospectively enrolled. Biopsies were analyzed using established histopathological and immunohistological criteria together with CXCL16 staining. CXCL16 was significantly enhanced in patients with inflammatory cardiomyopathy (78/127, 61.4%) as compared to patients with non-inflammatory cardiomyopathy (17/47, 36.2%, p=0.003). During a mean follow-up of 27.5 months, 20 patients (11.5%) reached the primary endpoint (death of all causes). Of all clinical (age, gender, NYHA functional class, systolic pulmonary artery pressure, left ventricular ejection fraction), laboratory (brain natriuretic peptide) and immunohistological (CXCL16) parameters tested, CXCL16 was the only independent predictor of death (hazard ratio 5.4; 95% confidence interval 1.2 to 24.0; p=0.027). Subgroup analysis revealed CXCL16 as a predictor of death in both patients with inflammatory and with non-inflammatory cardiomyopathy.
  
  
  CONCLUSIONS
  According to the present observations CXCL16 is enhanced in inflammatory cardiomyopathy and turned out as an independent predictor of death in patients with HF undergoing endomyocardial biopsy.
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany; Department of Physiology, University of Tübingen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Borst
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Schaub
authors.affiliation: Department of Physiology, University of Tübingen, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Walker
authors.affiliation: Department of Molecular Pathology, University of Tübingen, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Sauter
authors.affiliation: Department of Physiology, University of Tübingen, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Muenzer
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Gramlich
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Mueller
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Geisler
authors.affiliation: Department of Physiology, University of Tübingen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Lang
authors.affiliation: Department of Molecular Pathology, University of Tübingen, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Klingel
authors.affiliation: Department of Molecular Pathology, University of Tübingen, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kandolf
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Bigalke
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany. Electronic address: meinrad.gawaz@med.uni-tuebingen.de.
authors.forename: Meinrad
authors.initials: M
authors.lastname: Gawaz
authors.affiliation: Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Germany.
authors.forename: Christine S
authors.initials: CS
authors.lastname: Zuern
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D009202:Cardiomyopathies / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality*; D000075743:Chemokine CXCL16; D019743:Chemokines, CXC / Q000096:biosynthesis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051116:Receptors, Scavenger / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; C423727:CXCL16 protein, human; D000075743:Chemokine CXCL16; D019743:Chemokines, CXC; D051116:Receptors, Scavenger
keywords: Biomarker; CXCL16; Cardiomyopathy; Myocarditis; Prognosis