Circulating multimarker approach to identify patients with preclinical left ventricular remodelling and/or diastolic dysfunction - Université de Lorraine Access content directly
Journal Articles ESC Heart Failure Year : 2021

Circulating multimarker approach to identify patients with preclinical left ventricular remodelling and/or diastolic dysfunction

Abstract

Aims: Biomarkers reflecting myocardial fibrosis and inflammation have been individually associated with left ventricular hypertrophy (LVH) and diastolic dysfunction (DD). However, the added value of a fibrosis-inflammation multimarker approach in a populational setting is yet to be studied. We evaluated the value of a multimarker approach to detect LVH and DD in a large population-based cohort. Methods and results: In a prespecified analysis (BioSe-PreIC study) of the 4th visit of the STANISLAS cohort (1705 subjects, 47 ± 14 years, 47.4% men), we evaluated the ability of brain natriuretic peptide (BNP), Galectin-3 (GAL3), N-terminal propeptide of procollagen type III (P3NP), and soluble ST2 to predict LVH (LV mass > 116/100 g/m2 for men/women) and DD using discrimination (C-index) and reclassification analysis (NRI). Participants with LVH and/or DD had significantly higher levels of BNP, GAL3, and ST2. Overall, the predictive value of clinical variables for LVH and/or DD was good (C-index ranging from 0.76 to 0.82) and the addition of BNP, Gal3, P3NP, and ST2 moderately but significantly improved predictive value (delta C-index = 0.03, P = 0.03 for LVH and 0.01, P = 0.01 for DD) and reclassification (NRI = 25.3, P = 0.02 for LVH and NRI = 32.7 for DD, P < 0.0001). Gal3, P3NP, and ST2 significantly improved predictive value (delta C-index = 0.01, P = 0.01) and reclassification (NRI = 31.3, P < 0.0001) for DD of top of clinical variables and BNP. Conclusions: As the measurement of Gal3, P3NP, and ST2 results in marginal (even if significant) increase in the prediction of DD/LVH on top of routine evaluation, their systematic use should not be promoted in unselected healthy individuals to screen for preclinical DD. Further research is needed to determine whether a more personalized medicine approach combing proteomic and clinical scoring can amplify the added value of biomarkers to identify preclinical DD.
Fichier principal
Vignette du fichier
ehf2.13203.pdf (529.65 Ko) Télécharger le fichier
Origin : Publisher files allowed on an open archive

Dates and versions

hal-03146944 , version 1 (19-02-2021)

Identifiers

Cite

Olivier Huttin, Masatake Kobayashi, Joao Pedro Ferreira, Stefano Coiro, Erwan Bozec, et al.. Circulating multimarker approach to identify patients with preclinical left ventricular remodelling and/or diastolic dysfunction. ESC Heart Failure, 2021, ⟨10.1002/ehf2.13203⟩. ⟨hal-03146944⟩
49 View
72 Download

Altmetric

Share

Gmail Facebook X LinkedIn More