title: Serum Soluble Urokinase-Type Plasminogen Activator Receptor Is Associated with Low Left Ventricular Ejection Fraction and Elevated Plasma Brain-Type Natriuretic Peptide Level.
abstract: BACKGROUND
  Recent studies have suggested that soluble urokinase plasminogen activator receptor (suPAR), a biomarker of subclinical levels of inflammation, is significantly correlated with cardiovascular events.
  
  
  OBJECTIVE
  We investigated the association between suPAR and left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and plasma B-type natriuretic peptide (BNP) among cardiac inpatients.
  
  
  RESULTS
  In total, 242 patients (mean age 71.3 ± 9.8 years; 70 women) admitted to the cardiology department were enrolled in the study. suPAR was significantly correlated with LVEF (R = -0.24, P<0.001), LVMI (R = 0.16, P = 0.014) and BNP (R = 0.46, P<0.001). In logistic regression analysis, the highest suPAR tertile (> 3236 pg/mL) was associated with low LVEF (< 50%) and elevated BNP (> 300 pg/mL) with an odds ratio of 3.84 (95% confidence interval [CI], 1.22-12.1) and 5.36 (95% CI, 1.32-21.8), respectively, after adjusting for age, sex, log-transformed estimated glomerular filtration rate (log(eGFR)), C-reactive protein, and diuretic use. The association between suPAR and LVMI was not statistically significant. In multivariate receiver operating characteristic analysis, addition of log(suPAR) to the combination of age, sex, log(eGFR) and CRP incrementally improved the prediction of low LVEF (area under the curve [AUC], 0.827 to 0.852, P = 0.046) and BNP ≥ 300 pg/mL (AUC, 0.869 to 0.906; P = 0.029).
  
  
  CONCLUSIONS
  suPAR was associated with low LVEF and elevated BNP, but not with left ventricular hypertrophy, independent of CRP, renal function, and diuretic use among cardiac inpatients who were not undergoing chronic hemodialysis.
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Shu-Ichi
authors.initials: SI
authors.lastname: Fujita
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Maeda
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morita
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Fujisaka
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009929:Organ Size; D010343:Patient Admission; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012995:Solubility; D013318:Stroke Volume
chemical_list: D055293:Receptors, Urokinase Plasminogen Activator; D020097:Natriuretic Peptide, Brain