Comparing Biomarkers In Heart Failure With Preserved And Reduced Ejection Fraction

Objectives: To Compare circulating levels of biomarkers bettween heart failure with reduced ejection fraction(HF-REF)and heart failure with preserved ejection fraction(HF-PEF)and investigate the association of these biomarkers with left ventricular ejection fraction(LVEF).Methods:According to the level of left ventricular ejection fraction,86 heart failure patients were divided into two groups: heart failure with preserved ejection fraction group(LVEF≥50%,n=42)and heart failure with reduced ejection fraction group(LVEF < 50%,n=44),Controls without HF(n=40)included randomly sampled free-living adults aged ≥ 18 years,recruited from our department between December 2015 and February 2017.We measure circulating brain natriuretic peptide(BNP)and soluble suppression of tumorigenicity-2(sST2),cardiac troponin(cTnT,cTnI),Cystatin C(CysC),hypersensitivity C-reactive protein(hs-CRP)and left ventricular ejection fraction.Univariate Pearson’s(parametric)or Spearman’s(non-parametric)correlation were used to relate each biomarker to the LVEF.Results: Compared with patients with HF-PEF and HF-REF,HF-REF had higher levels of BNP(60 pg/mL vs.550 pg/mL),hsTnT(0.010 ng/mL vs.0.019 ng/mL),hsTnI(0.011 ng/mL vs.0.036 ng/mL)and sST2(27.70±7.26 ng/mL vs.37.49±10.17 ng/mL),but not hs-CRP(2.79 mg/L vs.3.44mg/L,p=0.523),In univariable analyses,all the individual biomarkers were negatively correlated with LVEF,including BNP(r=-0.771),sST2(r=-0.50),cTnT(r=-0.617),cTnI(r=-0.455),CysC(r=-0.318),hs-CRP(r=-0.370).Conclusion: 1.sST2,cTnT,cTnI,Cys C and BNP can be used as biomarkers to distinguish HF-PEF and HF-REF.Differences in levels of heart failure markers suggest that biomarkers reflecting pathophysiological pathways are different between heart failure with preserved(HFpEF)and reduced ejection fraction(HFrEF).2.BNP,sST2,cTnT and LVEF were correlated with the left ventricular ejection fraction.