title: Admission hypoxia-inducible factor 1α levels and in-hospital mortality in patients with acute decompensated heart failure.
abstract: BACKGROUND
  Hypoxia-inducible factor 1 (HIF-1) is a critical regulator for cellular oxygen balance. Myocardial hypoxia can induce the increased expression of HIF-1α. Our goals were to evaluate the value of HIF-1α in predicting death of patients with acute decompensated heart failure (ADHF) and describe the in vivo relationship between serum HIF-1α and N-terminal-pro-brain natriuretic peptide (NT-proBNP) levels.
  
  
  METHODS
  We included 296 patients who were consecutively admitted to the emergency department for ADHF. The primary end point was in-hospital death. The patients were categorized as HFrEF (patients with reduced systolic function) and HFpEF (patients with preserved systolic function) groups.
  
  
  RESULTS
  In our patients, the median admission HIF-1α level was 2.95 ± 0.85 ng/ml. The HIF-1α level was elevated significantly in HFrEF patients and deceased patients compared with HFpEF patients and patients who survived. The HIF-1α level was positively correlated with NT-proBNP and cardiac troponin T levels, and negatively correlated with left ventricular ejection fraction and systolic blood pressure. Kaplan-Meier curves revealed a significant increase in in-hospital mortality in ADHF patients with higher HIF-1α levels. Multivariable Cox regression analysis showed that HIF-1α levels were not correlated with the short-term prognosis of ADHF patients.
  
  
  CONCLUSIONS
  This is the first study to evaluate the circulating levels of HIF-1α in ADHF patients. Serum HIF-1α levels may reflect a serious state in patients with ADHF. Due to the limitations of the study, serum HIF-1α levels were not correlated with the in-hospital mortality based on regression analysis. Further studies are needed to demonstrate the diagnostic and/or prognostic role of HIF-1α as a risk biomarker in patients with ADHF.
authors.affiliation: Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 430074, China. marty007@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.affiliation: Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 430074, China. huaweilulwh@163.com.
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Lu
authors.affiliation: Department of Thoracic Surgery, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. wuxiaowei119@gmail.com.
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Wu
authors.affiliation: Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 430074, China. chengjian1201@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Cheng
authors.affiliation: College of Foreign Language, Huazhong Agriculture University, Wuhan, China. arlotus@mail.hzau.edu.cn.
authors.forename: Rong
authors.initials: R
authors.lastname: Ai
authors.affiliation: Institute of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China. zzhua2001@163.com.
authors.forename: Zi-hua
authors.initials: ZH
authors.lastname: Zhou
authors.affiliation: Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 430074, China. zhongzt2007@163.com.
authors.forename: Zhong-zhi
authors.initials: ZZ
authors.lastname: Tang
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*
chemical_list: D015415:Biomarkers; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit