Title
Analiza biomarkera miokardnog remodelovanja i njihov značaj u proceni kliničkih parametara kod pacijenata sa hroničnom srčanom slabošću
Creator
Mitić, Valentina T. 1977-
Copyright date
2020
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
Dozvoljavate samo preuzimanje i distribuciju dela, ako/dok se pravilno naznačava ime autora, bez ikakvih promena dela i bez prava komercijalnog korišćenja dela. Ova licenca je najstroža CC licenca. Osnovni opis Licence: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/deed.sr_LATN. Sadržaj ugovora u celini: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/legalcode.sr-Latn
Language
Serbian
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 30.10.2020.
Other responsibilities
mentor
Stojanović, Dijana- 1976
predsednik komisije
Bojanić, Vladmila
član komisije
Stojanović, Dijana
član komisije
Deljanin-Ilić, Marina
član komisije
Kocić, Gordana
član komisije
Beleslin, Branko
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Group
Katedra za patološku fiziologiju
Alternative title
The analysis of cardiac remodeling biomarkers and their significance in the assesment of clinical parameters in patients with chronic heart failure
Publisher
[V. T. Mitić]
Format
160 listova
description
Beleška o autoru: list 160;
Bibliografija: listovi 138-152.
description
Pathophysiology
Abstract (en)
Introduction. Heart failure (HF) is a heterogeneous clinical syndrome characterized by signs and symptoms caused by structural and/or functional cardiac abnormalities, resulting in reduced cardiac output or elevated intracardiac pressures during stress or rest. Cardiac remodeling biomarkers which are currently supported with relevant evidence regarding their monitoring and prognostic accuracy in chronic HF include: the soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1. Aim of the study. We established new objectives: by reflecting different pathophysiological processes in the course of HF progression, our hypothesis was that concentrations of cardiac remodeling biomarkers (sST2, galectin-3, GDF-15, syndecan-1) and BNP may vary significantly according to patients` classification based on the left ventricular ejection fraction (LVEF). Afterwards, we sought to assess the possible correlations of these biomarkers with relevant clinical, laboratory, and echocardiographic characteristics in the HF subgroups with: reduced, mid-range and preserved ejection fraction. Finally, we wanted to establish which biomarkers may be considered as predictors (independent and after multivariable adjustments) of changes in different clinical and echocardiographic parameters.
Patients and methods. This cross-sectional, single-center study was conducted at the Institute for Treatment and Rehabilitation „Niska Banja”, Niska Banja, and included 77 patients previously diagnosed with chronic heart failure, regardless of etiology. The diagnosis of HF was clinically confirmed according to current ESC 2016 guidelines. All patients underwent complete medical history assessment, physical examination, standard 12-lead electrocardiography, blood sampling, echocardiography and exercise stress test and afterwards the results were analyzed according to the stratification based on the ejection fraction category.
Results. We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p<0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p=0.002), galectin-3 (p<0.001), GDF-15 (p=0.011), syndecan-1 (p=0.006), whereas galectin-3 correlated after multivariable adjustments (p=0.001). Independent correlates of septum/posterior wall diameters, in HFpEF, were: sST2 (p=0.019; p=0.026), galectin-3 (p=0.011; p=0.009), GDF-15 (p=0.007; p=0.001), syndecan-1 (p=0.005; p=0.002). In HFrEF, only sST2,
adjusted, correlated with LVMI (p=0.010), whereas BNP independently correlated with LVMI (p=0.002), and EF (p=0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p=0.046) and HFrEF (p=0.024).
Conclusion. Cardiac remodeling biomarkers may be potential circulating markers of LV hypertrophy in HFpEF, which may help initiate the timely recognition of high-risk patients for disease progression.
Authors Key words
BNP, EF, galektin-3, GDF-15, sindekan-1, sST2,
srčana insuficijencija sa očuvanom EF, srčana insuficijencija sa graničnom EF, srčana insuficijencija sa redukovanom EF
Authors Key words
BNP, ejection fraction, galectin-3, GDF-15, HFpEF, HFmrEF, HFrEF, sST2, syndekan-1
Classification
616.12-008.46-036.1-074(043.3)
Subject
B 530
Type
Tekst
Abstract (en)
Introduction. Heart failure (HF) is a heterogeneous clinical syndrome characterized by signs and symptoms caused by structural and/or functional cardiac abnormalities, resulting in reduced cardiac output or elevated intracardiac pressures during stress or rest. Cardiac remodeling biomarkers which are currently supported with relevant evidence regarding their monitoring and prognostic accuracy in chronic HF include: the soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1. Aim of the study. We established new objectives: by reflecting different pathophysiological processes in the course of HF progression, our hypothesis was that concentrations of cardiac remodeling biomarkers (sST2, galectin-3, GDF-15, syndecan-1) and BNP may vary significantly according to patients` classification based on the left ventricular ejection fraction (LVEF). Afterwards, we sought to assess the possible correlations of these biomarkers with relevant clinical, laboratory, and echocardiographic characteristics in the HF subgroups with: reduced, mid-range and preserved ejection fraction. Finally, we wanted to establish which biomarkers may be considered as predictors (independent and after multivariable adjustments) of changes in different clinical and echocardiographic parameters.
Patients and methods. This cross-sectional, single-center study was conducted at the Institute for Treatment and Rehabilitation „Niska Banja”, Niska Banja, and included 77 patients previously diagnosed with chronic heart failure, regardless of etiology. The diagnosis of HF was clinically confirmed according to current ESC 2016 guidelines. All patients underwent complete medical history assessment, physical examination, standard 12-lead electrocardiography, blood sampling, echocardiography and exercise stress test and afterwards the results were analyzed according to the stratification based on the ejection fraction category.
Results. We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p<0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p=0.002), galectin-3 (p<0.001), GDF-15 (p=0.011), syndecan-1 (p=0.006), whereas galectin-3 correlated after multivariable adjustments (p=0.001). Independent correlates of septum/posterior wall diameters, in HFpEF, were: sST2 (p=0.019; p=0.026), galectin-3 (p=0.011; p=0.009), GDF-15 (p=0.007; p=0.001), syndecan-1 (p=0.005; p=0.002). In HFrEF, only sST2,
adjusted, correlated with LVMI (p=0.010), whereas BNP independently correlated with LVMI (p=0.002), and EF (p=0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p=0.046) and HFrEF (p=0.024).
Conclusion. Cardiac remodeling biomarkers may be potential circulating markers of LV hypertrophy in HFpEF, which may help initiate the timely recognition of high-risk patients for disease progression.
“Data exchange” service offers individual users metadata transfer in several different formats. Citation formats are offered for transfers in texts as for the transfer into internet pages. Citation formats include permanent links that guarantee access to cited sources. For use are commonly structured metadata schemes : Dublin Core xml and ETUB-MS xml, local adaptation of international ETD-MS scheme intended for use in academic documents.