title: Soluble CD146, a new endothelial biomarker of acutely decompensated heart failure.
abstract: BACKGROUND
  The present study involved both human cohorts and animal experiments to explore the performance of soluble CD146 (sCD146), a marker of endothelial function, as a diagnostic marker of acutely decompensated heart failure (ADHF), to determine the influence of patients' characteristics on that performance and to explore the potential application of CD146 in the pathophysiology of ADHF.
  
  
  RESULTS
  NT-proBNP and sCD146 were measured in three hundred ninety-one patients admitted to the emergency department for acute dyspnea. ROC curve analysis demonstrated that AUCs for ADHF diagnosis in dyspneic patients were 0.86 (95% CI: 0.82-0.90) for sCD146 and 0.90 (95% CI: 0.86-0.92) for NT-proBNP. Subgroup analyses demonstrated that adding sCD146 to NT-proBNP improved the diagnostic performance for patients lying in the gray zone of NT-proBNP (p=0.02) and could be especially useful for ruling-out ADHF. An experimental model of ADHF in rats using thoracic aortic constriction suggests that CD146 is expressed in the intima of large arteries and associated with both left ventricular function and organ congestion.
  
  
  CONCLUSIONS
  sCD146, a marker of endothelial function, seems to be as powerful as NT-proBNP is used to detect the cardiac origin of an acute dyspnea. The combination of sCD146 and NT-proBNP may have better performance than NT-proBNP used alone in particular for patients underlying in the "gray" zone and could therefore be an improved option for ruling-out ADHF. Both experimental and human data suggest that CD146 is related to systolic left ventricular function and to organ congestion.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France. Electronic address: etienne.gayat@lrb.aphp.fr.
authors.forename: Etienne
authors.initials: E
authors.lastname: Gayat
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Caillard
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Emergency Department, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Saïd
authors.initials: S
authors.lastname: Laribi
authors.affiliation: University Hospital Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.affiliation: UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France.
authors.forename: Malha
authors.initials: M
authors.lastname: Sadoune
authors.affiliation: UMR-S 942, INSERM, Paris, France; Department of Cardiology EA3920, University Hospital Jean Minjoz, Besancon, France.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Seronde
authors.affiliation: San Diego VA Medical Center, University of California, San Diego, CA, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Maisel
authors.affiliation: Cardiovascular Center, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: Bartunek
authors.affiliation: Cardiovascular Center, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Vanderheyden
authors.affiliation: Department of Cardiology, AZ Maria Middelares Hospital Gent, University Gent, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Desutter
authors.affiliation: Hasselt University, Heart Centre Hasselt, Hasselt, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Dendale
authors.affiliation: SQU4RE, Lokeren, Belgium.
authors.forename: Gregoire
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Hospital Geral de Santo Antonio, Porto, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Tavares
authors.affiliation: UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France; Department of Cardiology, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen-Solal
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France.
authors.forename: Jane-Lise
authors.initials: JL
authors.lastname: Samuel
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S 942, INSERM, Paris, France; Université Paris Diderot, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015415:Biomarkers / Q000097:blood; D051929:CD146 Antigen / Q000097:blood*; D004195:Disease Models, Animal; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D051381:Rats; D014664:Vasodilation / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D015415:Biomarkers; D051929:CD146 Antigen; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Biomarker; Congestion; Diagnosis; Endothelial; Heart failure