Limits...
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

EO levels (blue = preoperative; red = postoperative) according to each NYHA class (p = 0.013 after correction for sex, age, BMI, preoperative GFR, EuroSCORE, and baseline level of EO).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4644558&req=5

fig3: EO levels (blue = preoperative; red = postoperative) according to each NYHA class (p = 0.013 after correction for sex, age, BMI, preoperative GFR, EuroSCORE, and baseline level of EO).

Mentions: Finally, those patients with a more severe heart failure index, expressed as NYHA class, have a higher baseline EO plasmatic level (p = 0.047). According to each NYHA class, mean (±SD) EO preoperative level (expressed in pmol/L) was as follows: 179.84 ± 107.58 for class I; 192.07 ± 107.45 for class II; 209.08 ± 125.67 for class III; and 247.98 ± 133.52 for class IV. More interesting, we observed the same trend, but with a stronger evidence, for postoperative EO level (mean ± SD, resp.: 272.81 ± 127.59 versus 276.89 ± 126.50 versus 333.62 ± 164.78 versus 427.79 ± 246.65 pmol/L) according to NYHA class (Kruskal-Wallis p = 0.0001; Figure 3). Correlation between postoperative EO and NYHA class was corrected for clinical variables (see above) and also for preoperative level of EO (p = 0.013).


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)

EO levels (blue = preoperative; red = postoperative) according to each NYHA class (p = 0.013 after correction for sex, age, BMI, preoperative GFR, EuroSCORE, and baseline level of EO).
© Copyright Policy
Related In: Results  -  Collection

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

fig3: EO levels (blue = preoperative; red = postoperative) according to each NYHA class (p = 0.013 after correction for sex, age, BMI, preoperative GFR, EuroSCORE, and baseline level of EO).
Mentions: Finally, those patients with a more severe heart failure index, expressed as NYHA class, have a higher baseline EO plasmatic level (p = 0.047). According to each NYHA class, mean (±SD) EO preoperative level (expressed in pmol/L) was as follows: 179.84 ± 107.58 for class I; 192.07 ± 107.45 for class II; 209.08 ± 125.67 for class III; and 247.98 ± 133.52 for class IV. More interesting, we observed the same trend, but with a stronger evidence, for postoperative EO level (mean ± SD, resp.: 272.81 ± 127.59 versus 276.89 ± 126.50 versus 333.62 ± 164.78 versus 427.79 ± 246.65 pmol/L) according to NYHA class (Kruskal-Wallis p = 0.0001; Figure 3). Correlation between postoperative EO and NYHA class was corrected for clinical variables (see above) and also for preoperative level of EO (p = 0.013).

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