title: Increased Transforming Growth Factor-β Levels Associated With Cardiac Adverse Events in Hypertrophic Cardiomyopathy.
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease characterized by ventricular hypertrophy, myocardial fibrosis, and impaired ventricular relaxation. The exact mechanisms by which fibrosis is caused remain unknown.
  
  
  OBJECTIVE
  Circulating TGF-β is related to poor prognosis in HCM.
  
  
  METHODS
  We compared TGF-β levels of 49 HCM patients with those of 40 non-HCM patients. We followed the patients with HCM for 18 months and divided them into 2 groups: low TGF-β (≤ 4877 pg/mL) and high TGF-β (> 4877 pg/mL). We compared the 2 groups in terms of brain natriuretic peptide (BNP), echocardiographic parameters, and clinical outcomes including myocardial infarction, arrhythmias, implantable cardioverter-defibrillator implantation, hospitalization, New York Heart Association (NYHA) class, acute heart failure, and mortality.
  
  
  RESULTS
  The HCM patients had higher TGF-β levels than those in the control group (P = 0.005). In the follow-up, those in the high TGF-β group had higher BNP levels, larger left-atrial size, thicker interventricular septum, NYHA class, more hospitalizations, and a greater number of clinical adverse events (P < 0.001, P = 0.01, P < 0.001, P = 0.002, P < 0.001 and P = 0.003, respectively). TGF-β level of > 4877 pg/mL can predict adverse events with a specificity of 75% and a sensitivity of 72% (P = 0.014). In multivariate regression analysis, TGF-β, BNP, and interventricular septum thickness were significantly associated with adverse events (P = 0.028, P = 0.030, and P = 0.034, respectively).
  
  
  CONCLUSIONS
  The TGF-β level is higher in HCM patients and associated with a poor prognosis in HCM.
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Ayça
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Sahin
authors.affiliation: Department of Biochemistry, Bağcılar Education and Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Suat Hayri
authors.initials: SH
authors.lastname: Kucuk
authors.affiliation: Medical Faculty, Department of Cardiology, Muğla Sıtkı Kocman University, Muğla, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akin
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Kafadar
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Avşar
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Ilker Ilhan
authors.initials: II
authors.lastname: Avci
authors.affiliation: Department of Cardiology, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Gungor
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Okuyan
authors.affiliation: Department of Cardiology, Bağcılar Education Research Hospital, Bağcılar, Istanbul, Turkey.
authors.forename: Mustafa Hakan
authors.initials: MH
authors.lastname: Dinckal
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D053773:Transforming Growth Factor beta1 / Q000097:blood*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D053773:Transforming Growth Factor beta1; D020097:Natriuretic Peptide, Brain