title: β2-Microglobulin and TIMP1 Are Linked Together in Cardiorenal Remodeling and Failure.
abstract: OBJECTIVE
  The cardiorenal syndrome is a complication in patients hospitalized with chronic heart failure (CHF). The β2-microglobulin (b2M) level is an index of decreased glomerular filtration rate (GFR), tissue turnover and inflammation. It is an emerging new predictive marker of cardiovascular events and mortality, but its role as a biomarker of cardiorenal remodeling and failure is still unknown. TIMP1, an endogenous tissue inhibitor of activated matrix metalloproteinases, is a biomarker of heart remodeling and failure. We aimed to evaluate the circulating profile of b2M and TIMP1 in CHF patients, in sedentary controls with no tissue remodeling and in veteran athletes with physiological cardiorenal remodeling and athlete's heart (AH).
  
  
  METHODS
  We investigated the plasma levels of b2M and TIMP1 in 24 subjects with CHF without primitive renal disease, in 25 sedentary controls and in 30 veteran marathoners with AH over 50 years.
  
  
  RESULTS
  The b2M and TIMP1 levels were higher in CHF patients, and there was a correlation between them (r = 0.5287, p < 0.0095). The b2M level correlated with the severity of cardiorenal impairment: with proBNP (r = 0.66, p > 0.0007), percent ejection fraction (r = -0.56, p = 0.0162) and GFR (r = 0.83, p < 0.0001). b2M was also correlated with TIMP1 in AH subjects (r = 0.7548, p < 0.0001) but not in controls. This correlation was independent from GFR in both CHF patients and sedentary controls.
  
  
  CONCLUSIONS
  In CHF patients, the plasma levels of b2M and TIMP1 were linked together and correlated with the severity of cardiorenal failure. Moreover, a strong correlation between b2M and TIMP1 characterized cardiovascular remodeling not only in CHF patients but also in AH subjects. These findings suggest that clinicians should use b2M and TIMP1 as associated biomarkers of cardiorenal remodeling and failure.
authors.affiliation: Department of Human Morphology and Applied Biology, Pisa, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Vianello
authors.affiliation: Department of Experimental Pathology BMIE, Pisa, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Caponi
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Galetta
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Franzoni
authors.affiliation: Department of Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Taddei
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Department of Experimental Pathology BMIE, Pisa, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Pietrini
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Santoro
keywords: Cardiorenal failure; TIMP1; β2-Microglobulin