title: Serial Echocardiographic Characteristics, Novel Biomarkers and Cachexia Development in Patients with Stable Chronic Heart Failure.
abstract: Little is known regarding objective predictors of cachexia affecting patients with heart failure (HF). We studied 108 stable chronic systolic HF patients with serial echocardiography and biomarker measurements over 10 months. Cachexia was defined as weight loss ≥5 % from baseline or final BMI <20 kg/m2; 18.5 % developed cachexia. While there were no significant differences in baseline or serial echocardiographic measures in those developing cachexia, we found significant differences in baseline amino-terminal pro-B type natriuretic peptide (NT-proBNP), highly sensitive troponin I, sST2, and endothelin-1. Baseline log NT-proBNP (hazard ratio (HR) = 2.57, p = 0.004) and edema (HR = 3.36, p = 0.04) were predictive of cachexia in an adjusted analysis. When serial measurement of biomarkers was considered, only percent time with NT-proBNP ≥1000 pg/mL was predictive of cachexia. Thus, a close association exists between baseline and serial measurement of NT-proBNP and HF cachexia.
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.|Harvard Clinical Research Institute, Boston, MA, USA.
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Gaggin
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Arianna M
authors.initials: AM
authors.lastname: Belcher
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Parul U
authors.initials: PU
authors.lastname: Gandhi
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Nasrien E
authors.initials: NE
authors.lastname: Ibrahim
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA. jjanuzzi@mgh.harvard.edu.|Harvard Clinical Research Institute, Boston, MA, USA. jjanuzzi@mgh.harvard.edu.
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
mesh_terms: D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002100:Cachexia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002908:Chronic Disease; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D019210:Troponin I; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Biomarkers; Cachexia; Heart failure; Outcomes