Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Plasma tumour and metabolism related biomarkers AMBP, LPL and Glyoxalase I differentiate heart failure with preserved ejection fraction with pulmonary hypertension from pulmonary arterial hypertension

Ahmed, Salaheldin LU orcid ; Ahmed, Abdulla LU orcid and Rådegran, Göran LU (2021) In International Journal of Cardiology 345. p.68-76
Abstract

Background: Discrimination of heart failure with preserved ejection fraction with pulmonary hypertension (HFpEF-PH) from pulmonary arterial hypertension (PAH) is crucial for clinical management but may be challenging due to similarities in clinical and comorbid characteristics. We aimed to investigate tumour and metabolism related proteins in differentiating HFpEF-PH from PAH. Methods: Sixty-nine tumour and metabolism plasma proteins were analysed with proximity extension assay in heathy controls (n = 20), patients with PAH (n = 48) and LHF-PH (n = 67) [HFpEF-PH (n = 31) and HF reduced EF-PH (n = 36)]. Haemodynamics were assessed with right heart catheterization. Results: The plasma levels of alpha-1-microglobulin/bikunin precursor... (More)

Background: Discrimination of heart failure with preserved ejection fraction with pulmonary hypertension (HFpEF-PH) from pulmonary arterial hypertension (PAH) is crucial for clinical management but may be challenging due to similarities in clinical and comorbid characteristics. We aimed to investigate tumour and metabolism related proteins in differentiating HFpEF-PH from PAH. Methods: Sixty-nine tumour and metabolism plasma proteins were analysed with proximity extension assay in heathy controls (n = 20), patients with PAH (n = 48) and LHF-PH (n = 67) [HFpEF-PH (n = 31) and HF reduced EF-PH (n = 36)]. Haemodynamics were assessed with right heart catheterization. Results: The plasma levels of alpha-1-microglobulin/bikunin precursor (AMBP) and lipoprotein lipase (LPL), were higher in HFpEF-PH compared to healthy controls (p < 0.01), HFrEF-PH (p < 0.05), and PAH (p < 0.001). Glyoxalase I levels were higher in HFpEF-PH and HFrEF-PH compared to controls (p < 0.001) and PAH (p < 0.001). Each of plasma AMBP, LPL, and glyoxalase I, adjusted for age and sex in multivariable logistic regression models, could differentiate HFpEF-PH from PAH, with areas under the receiver operating characteristic curve (AUC) of 0.81, 0.84 and 0.79, respectively. The combination of AMBP, LPL and glyoxalse I yielded the largest AUC of 0.87 [95% confidence interval (0.79–0.95)] in discriminating HFpEF-PH from PAH, with a sensitivity of 87.1% and a specificity of 85.4%. In HFpEF-PH, the plasma levels of AMBP correlated with pulmonary arterial wedge pressure (rs = −0.42, p = 0.018). Conclusions: Plasma AMBP, LPL and glyoxalase I may facilitate the distinction of HFpEF-PH from PAH. Larger clinical studies are encouraged to confirm and validate our findings.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarkers, Haemodynamics, Heart failure with preserved ejection fraction, Prognosis, Pulmonary arterial hypertension, Pulmonary hypertension due to left heart disease
in
International Journal of Cardiology
volume
345
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85119248812
  • pmid:34710494
ISSN
0167-5273
DOI
10.1016/j.ijcard.2021.10.136
language
English
LU publication?
yes
id
2875df57-963b-4176-9252-f866e74c3278
date added to LUP
2021-12-08 14:00:42
date last changed
2024-07-28 02:32:40
@article{2875df57-963b-4176-9252-f866e74c3278,
  abstract     = {{<p>Background: Discrimination of heart failure with preserved ejection fraction with pulmonary hypertension (HFpEF-PH) from pulmonary arterial hypertension (PAH) is crucial for clinical management but may be challenging due to similarities in clinical and comorbid characteristics. We aimed to investigate tumour and metabolism related proteins in differentiating HFpEF-PH from PAH. Methods: Sixty-nine tumour and metabolism plasma proteins were analysed with proximity extension assay in heathy controls (n = 20), patients with PAH (n = 48) and LHF-PH (n = 67) [HFpEF-PH (n = 31) and HF reduced EF-PH (n = 36)]. Haemodynamics were assessed with right heart catheterization. Results: The plasma levels of alpha-1-microglobulin/bikunin precursor (AMBP) and lipoprotein lipase (LPL), were higher in HFpEF-PH compared to healthy controls (p &lt; 0.01), HFrEF-PH (p &lt; 0.05), and PAH (p &lt; 0.001). Glyoxalase I levels were higher in HFpEF-PH and HFrEF-PH compared to controls (p &lt; 0.001) and PAH (p &lt; 0.001). Each of plasma AMBP, LPL, and glyoxalase I, adjusted for age and sex in multivariable logistic regression models, could differentiate HFpEF-PH from PAH, with areas under the receiver operating characteristic curve (AUC) of 0.81, 0.84 and 0.79, respectively. The combination of AMBP, LPL and glyoxalse I yielded the largest AUC of 0.87 [95% confidence interval (0.79–0.95)] in discriminating HFpEF-PH from PAH, with a sensitivity of 87.1% and a specificity of 85.4%. In HFpEF-PH, the plasma levels of AMBP correlated with pulmonary arterial wedge pressure (r<sub>s</sub> = −0.42, p = 0.018). Conclusions: Plasma AMBP, LPL and glyoxalase I may facilitate the distinction of HFpEF-PH from PAH. Larger clinical studies are encouraged to confirm and validate our findings.</p>}},
  author       = {{Ahmed, Salaheldin and Ahmed, Abdulla and Rådegran, Göran}},
  issn         = {{0167-5273}},
  keywords     = {{Biomarkers; Haemodynamics; Heart failure with preserved ejection fraction; Prognosis; Pulmonary arterial hypertension; Pulmonary hypertension due to left heart disease}},
  language     = {{eng}},
  pages        = {{68--76}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{Plasma tumour and metabolism related biomarkers AMBP, LPL and Glyoxalase I differentiate heart failure with preserved ejection fraction with pulmonary hypertension from pulmonary arterial hypertension}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2021.10.136}},
  doi          = {{10.1016/j.ijcard.2021.10.136}},
  volume       = {{345}},
  year         = {{2021}},
}