title: Differences in biochemical and genetic biomarkers in patients with heart failure of various etiologies.
abstract: OBJECTIVE
  To evaluate whether biomarkers reflecting pathophysiological pathways and selected single nucleotide polymorphisms differ between patients (pts) with heart failure (HF).
  
  
  METHODS
  110 pts with were involved, including HF pts with preserved ejection fraction (HFpEF, n=51) with hypertensive origin, HF pts with reduced ejection fraction (HFrEF) with ischemic aetiology (ICM) (n=32) and HFrEF with dilated cardiomyopathy (DCM) (n=27). We assessed selected HF biomarkers, echocardiographic examinations and functional polymorphisms selected from six candidate genes: CYP27B1, NOS3, IL-6, TGF beta, TNF alpha, and PPAR gamma.
  
  
  RESULTS
  Higher concentrations of TNF alpha were observed in pts with hypertensive HFpEF compared to pts with DCM (p=0.008). Pts with HFpEF had higher concentrations of TGF beta 1 compared to DCM and ICM (p=0.0001 and p=0.0003, respectively). For the NOS3 -786 C/T rs2070744 polymorphism in DCM there were significantly more CT heterozygotes than in ICM and HFpEF. In multivariate analysis TGF beta 1 (p=0.001) and syndecan 4 (p=0.001) were the only factors distinguishing HFrEF pts with DCM vs HFpEF and also TGF beta 1 (p=0.001) and syndecan 4 (p=0.023) were the only factors distinguishing HFrEF pts with ICM vs HFpEF pts.
  
  
  CONCLUSIONS
  Inflammation mediated through TNF alpha and TGF beta 1 may represent an important component of an inflammatory response that partially drives the pathophysiology of HFpEF. NOS3 -786 C/T rs2070744 polymorphism in DCM may serve as a marker for more rapid progression of heart failure. The only biomarkers independently distinguishing HFpEF and HFrEF are syndecan 4 and TGF beta 1.
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland. Electronic address: agatbiel7@poczta.onet.pl.
authors.forename: Agata
authors.initials: A
authors.lastname: Bielecka-Dabrowa
authors.affiliation: Department of Medical Biotechnology, Medical University of Lodz, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Sakowicz
authors.affiliation: Chair of Statistical Methods, Faculty of Economics and Sociology, University of Lodz, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Misztal
authors.affiliation: Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
authors.affiliation: Department of Medicine Division of Gerontology, Geriatrics and Palliative Care, University of Washington, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Medical Biotechnology, Medical University of Lodz, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Pietrucha
authors.affiliation: Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000368:Aged; D000613:Aminobutyrates / Q000494:pharmacology; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology; D001713:Biphenyl Compounds; D002311:Cardiomyopathy, Dilated / Q000150:complications; D004338:Drug Combinations; D005260:Female; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D053671:Syndecan-4 / Q000235:genetics*; D013777:Tetrazoles / Q000494:pharmacology; D053773:Transforming Growth Factor beta1 / Q000235:genetics*; D000068756:Valsartan
chemical_list: D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds; D004338:Drug Combinations; D005819:Genetic Markers; C508304:SDC4 protein, human; D053671:Syndecan-4; C508960:TGFB1 protein, human; D013777:Tetrazoles; D053773:Transforming Growth Factor beta1; D020097:Natriuretic Peptide, Brain; D000068756:Valsartan; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III; C549068:sacubitril and valsartan sodium hydrate drug combination
keywords: Biomarkers; Dilated cardiomyopathy; Heart failure with preserved ejection fraction; Heart failure with reduced ejection fraction