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Endogenous Ouabain: An Old Cardiotonic Steroid as a New Biomarker of Heart Failure and a Predictor of Mortality after Cardiac Surgery.

Simonini M, Pozzoli S, Bignami E, Casamassima N, Messaggio E, Lanzani C, Frati E, Botticelli IM, Rotatori F, Alfieri O, Zangrillo A, Manunta P - Biomed Res Int (2015)

Bottom Line: Moreover, a different plasmatic EO level (both preoperative and postoperative) was found according to NYHA class (p = 0.013).All these results have been replicated on an independent cohort of patients (147 subjects from US).Finally, a higher EO level in the immediate postoperative time was indicative of a more severe cardiological condition and it was associated with increased perioperative mortality risk (p = 0.023 for 30-day morality).

View Article: PubMed Central - PubMed

Affiliation: Genomics of Renal Diseases and Hypertension Department, "Vita-Salute" San Raffaele University, Chair of Nephrology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

ABSTRACT
Cardiovascular diseases remain the main cause of mortality and morbidity worldwide; primary prevention is a priority for physicians. Biomarkers are useful tools able to identify high-risk individuals, guide treatments, and determine prognosis. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure. In a population of 845 patients undergoing elective cardiac surgery, we have investigated the relationships between EO and echocardiography parameters/plasmatic biomarker of cardiac function. EO was found to be correlated negatively with left ventricular EF (p = 0.001), positively with Cardiac End-Diastolic Diameter (p = 0.047), and positively with plasmatic NT-proBNP level (p = 0.02). Moreover, a different plasmatic EO level (both preoperative and postoperative) was found according to NYHA class (p = 0.013). All these results have been replicated on an independent cohort of patients (147 subjects from US). Finally, a higher EO level in the immediate postoperative time was indicative of a more severe cardiological condition and it was associated with increased perioperative mortality risk (p = 0.023 for 30-day morality). Our data suggest that preoperative and postoperative plasmatic EO level identifies patients with a more severe cardiovascular presentation at baseline. These patients have a higher risk of morbidity and mortality after cardiac surgery.

No MeSH data available.


Related in: MedlinePlus

Correlation between baseline (preoperative) EO level and cardiac left ventricular ejection fraction (LVEF). Patients with higher Endogenous Ouabain baseline levels are those with lower LVEF (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for sex, age, BMI, preoperative GFR, and clinical presentation expressed as EuroSCORE)).
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fig1: Correlation between baseline (preoperative) EO level and cardiac left ventricular ejection fraction (LVEF). Patients with higher Endogenous Ouabain baseline levels are those with lower LVEF (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for sex, age, BMI, preoperative GFR, and clinical presentation expressed as EuroSCORE)).

Mentions: We found a correlation between baseline (preoperative) EO level and cardiac ejection fraction. Patients with a higher baseline Endogenous Ouabain are those with lower left ventricular ejection fraction (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for covariates); Figure 1). Results remain significant even after LVEF was recorded according to EuroSCORE [39] classification (three classes: EF < 30%; EF 30–50%; EF > 50%; Kruskal-Wallis p = 0.001 (0.013 after correction for covariates); Figure 2). Moreover a positive correlation between preoperative level of Endogenous Ouabain and Cardiac End-Diastolic Diameter was also observed (Pearson Correlation with logarithmic EO: r = 0.147; p = 0.047 (0.05 after correction for covariates)). Furthermore, a positive correlation was observed also between the plasmatic values of EO and NT-proBNP (Pearson Correlation with logarithmic EO: r = 0.321; p = 0.02 (0.021 after correction for covariates)). Statistical adjustment was made for sex, age, BMI, preoperative GFR, and clinical presentation (summarized by EuroSCORE preoperative value).


Endogenous Ouabain: An Old Cardiotonic Steroid as a New Biomarker of Heart Failure and a Predictor of Mortality after Cardiac Surgery.

Simonini M, Pozzoli S, Bignami E, Casamassima N, Messaggio E, Lanzani C, Frati E, Botticelli IM, Rotatori F, Alfieri O, Zangrillo A, Manunta P - Biomed Res Int (2015)

Correlation between baseline (preoperative) EO level and cardiac left ventricular ejection fraction (LVEF). Patients with higher Endogenous Ouabain baseline levels are those with lower LVEF (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for sex, age, BMI, preoperative GFR, and clinical presentation expressed as EuroSCORE)).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644558&req=5

fig1: Correlation between baseline (preoperative) EO level and cardiac left ventricular ejection fraction (LVEF). Patients with higher Endogenous Ouabain baseline levels are those with lower LVEF (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for sex, age, BMI, preoperative GFR, and clinical presentation expressed as EuroSCORE)).
Mentions: We found a correlation between baseline (preoperative) EO level and cardiac ejection fraction. Patients with a higher baseline Endogenous Ouabain are those with lower left ventricular ejection fraction (Pearson Correlation with logarithmic EO r = 0.135; p = 0.001 (0.048 after correction for covariates); Figure 1). Results remain significant even after LVEF was recorded according to EuroSCORE [39] classification (three classes: EF < 30%; EF 30–50%; EF > 50%; Kruskal-Wallis p = 0.001 (0.013 after correction for covariates); Figure 2). Moreover a positive correlation between preoperative level of Endogenous Ouabain and Cardiac End-Diastolic Diameter was also observed (Pearson Correlation with logarithmic EO: r = 0.147; p = 0.047 (0.05 after correction for covariates)). Furthermore, a positive correlation was observed also between the plasmatic values of EO and NT-proBNP (Pearson Correlation with logarithmic EO: r = 0.321; p = 0.02 (0.021 after correction for covariates)). Statistical adjustment was made for sex, age, BMI, preoperative GFR, and clinical presentation (summarized by EuroSCORE preoperative value).

Bottom Line: Moreover, a different plasmatic EO level (both preoperative and postoperative) was found according to NYHA class (p = 0.013).All these results have been replicated on an independent cohort of patients (147 subjects from US).Finally, a higher EO level in the immediate postoperative time was indicative of a more severe cardiological condition and it was associated with increased perioperative mortality risk (p = 0.023 for 30-day morality).

View Article: PubMed Central - PubMed

Affiliation: Genomics of Renal Diseases and Hypertension Department, "Vita-Salute" San Raffaele University, Chair of Nephrology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

ABSTRACT
Cardiovascular diseases remain the main cause of mortality and morbidity worldwide; primary prevention is a priority for physicians. Biomarkers are useful tools able to identify high-risk individuals, guide treatments, and determine prognosis. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure. In a population of 845 patients undergoing elective cardiac surgery, we have investigated the relationships between EO and echocardiography parameters/plasmatic biomarker of cardiac function. EO was found to be correlated negatively with left ventricular EF (p = 0.001), positively with Cardiac End-Diastolic Diameter (p = 0.047), and positively with plasmatic NT-proBNP level (p = 0.02). Moreover, a different plasmatic EO level (both preoperative and postoperative) was found according to NYHA class (p = 0.013). All these results have been replicated on an independent cohort of patients (147 subjects from US). Finally, a higher EO level in the immediate postoperative time was indicative of a more severe cardiological condition and it was associated with increased perioperative mortality risk (p = 0.023 for 30-day morality). Our data suggest that preoperative and postoperative plasmatic EO level identifies patients with a more severe cardiovascular presentation at baseline. These patients have a higher risk of morbidity and mortality after cardiac surgery.

No MeSH data available.


Related in: MedlinePlus