title: Inflammation versus mechanical stretch biomarkers over time in acutely decompensated heart failure with reduced ejection fraction.
abstract: Heart failure can be associated with inflammation but it is unclear if inflammation is directly related to hemodynamic worsening or is an independent pathway. Our aim was to investigate inflammation and mechanical stress using serial measurements of biomarkers in acute and chronic heart failure with reduced ejection fraction (AHF and CHF).
  
  
  METHODS
  The following biomarkers were measured on admission, at discharge and one month after discharge: B-type natriuretic peptide (BNP), high-sensitivity C-Reactive protein (hsCRP), Tumour Necrosis Factor alpha (TNFα), interleukin 6 (IL6), myeloperoxidase (MPO), suppression of tumorigenicity 2 (ST2), mid-regional pro-adrenomedullin (MR-proADM), galectin 3 (Gal3), Growth differentiating factor 15 (GDF15) and procalcitonin (PCT).
  
  
  RESULTS
  In control CHF group (n=20, 69±11y, NYHA 1-2), most biomarker levels were low and stable over time. In AHF (n=55, 71±14y), BNP, ST2 and GDF15 levels were highly increased on admission and then decreased rapidly with clinical improvement; BNP, ST2 and GDF15 levels were statistically correlated (r=0.64, 0.46 and 0.39; p<0.001 for both). Both hsCRP, MPO, TNFα and Gal3 levels were increased in most AHF patients (70, 56, 83 and 98% respectively) with poor change over time. HsCRP, MPO and TNFα levels were correlated. IL6, MR-proADM and PCT levels were slightly increased, without change over time. Highest quartiles of BNP and ST2 were associated with death or readmission at one year (HR 2.33 [95CI 1.13-4.80] and 2.42 [1.27-4.60]).
  
  
  CONCLUSIONS
  AHF is associated with systemic inflammation. This inflammatory response continued up to one month after discharge despite normalisation of mechanical stress-related markers.
authors: AP-HP Lariboisiere Hospital, Department of cardiology, Paris, France.
authors: M
authors: M
authors: Boulogne
authors: INSERM U942, Lariboisiere Hospital, Paris, France.
authors: M
authors: M
authors: Sadoune
authors: INSERM U942, Lariboisiere Hospital, Paris, France; AP-HP Lariboisiere Hospital, Department of biochemistry, Paris, France.
authors: J M
authors: JM
authors: Launay
authors: AP-HP Lariboisiere Hospital, Department of cardiology, Paris, France.
authors: M
authors: M
authors: Baudet
authors: AP-HP Lariboisiere Hospital, Department of cardiology, Paris, France; INSERM U942, Lariboisiere Hospital, Paris, France; University Paris Diderot, Paris, France.
authors: A
authors: A
authors: Cohen-Solal
authors: AP-HP Lariboisiere Hospital, Department of cardiology, Paris, France; INSERM U942, Lariboisiere Hospital, Paris, France; University Paris Diderot, Paris, France. Electronic address: damien.logeart@aphp.fr.
authors: D
authors: D
authors: Logeart
mesh_terms: D053607:Adrenomedullin / Q000097:blood; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D013318:Stroke Volume / Q000502:physiology*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin; D002097:C-Reactive Protein
keywords: Biomarkers; Heart failure; Inflammation