Pentraxin 3 Is a New Inflammatory Marker Correlated With Left Ventricular Diastolic Dysfunction and Heart Failure With Normal Ejection Fraction

Objectives This study investigated the clinical significance of plasma pentraxin 3 (PTX3) levels in patients with heart failure with normal ejection fraction (HFNEF) and whether PTX3 is produced from coronary circulation. Background Pentraxin 3 is a novel inflammatory marker and a member of pentraxi...

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Published in:Journal of the American College of Cardiology 2011-02, Vol.57 (7), p.861-869
Main Authors: Matsubara, Junichi, MD, Sugiyama, Seigo, MD, PhD, Nozaki, Toshimitsu, MD, PhD, Sugamura, Koichi, MD, PhD, Konishi, Masaaki, MD, Ohba, Keisuke, MD, Matsuzawa, Yasushi, MD, Akiyama, Eiichi, MD, Yamamoto, Eiichiro, MD, PhD, Sakamoto, Kenji, MD, PhD, Nagayoshi, Yasuhiro, MD, PhD, Kaikita, Koichi, MD, PhD, Sumida, Hitoshi, MD, PhD, Kim-Mitsuyama, Shokei, MD, PhD, Ogawa, Hisao, MD, PhD
Format: Article
Language:English
Subjects:
Age
Aged
Biological and medical sciences
Biomarkers
Biomarkers - blood
Body mass index
C-Reactive Protein - analysis
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular system
Cholesterol
Confidence intervals
Coronary Circulation
Diabetes
Enzymes
Female
Flow velocity
Fractions
Heart
Heart failure
Heart Failure - blood
heart failure with normal ejection fraction
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Hypertension
Inflammation
Internal Medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
left ventricular diastolic dysfunction
Logistics
Male
Medical sciences
Pathogenesis
pentraxin 3
Regression Analysis
Serum Amyloid P-Component - analysis
Stroke Volume
Ventricular Dysfunction, Left - blood
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Summary:Objectives This study investigated the clinical significance of plasma pentraxin 3 (PTX3) levels in patients with heart failure with normal ejection fraction (HFNEF) and whether PTX3 is produced from coronary circulation. Background Pentraxin 3 is a novel inflammatory marker and a member of pentraxin superfamily including C-reactive protein (CRP). The relationship between inflammatory markers and HFNEF remains unclear. Methods We measured peripheral blood levels of PTX3, high-sensitivity CRP, tumor necrosis factor-alpha, and interleukin-6 in 323 patients comprising 82 HFNEF, 70 heart failure (HF) with reduced EF, and 171 non-HF patients. Levels of PTX3 were also measured at the aortic root and the coronary sinus in 75 patients. Results The levels of PTX3, tumor necrosis factor-alpha, and interleukin-6, but not high-sensitivity CRP, were significantly higher in HFNEF patients than in non-HF patients. Multivariate logistic regression analysis identified only high levels of PTX3 as the independent inflammatory marker correlated with the presence of HFNEF in patients with normal left ventricular (LV) EF (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.11 to 1.98, p < 0.01) and with the presence of left ventricular diastolic dysfunction (LVDD) in non-HF patients (OR: 1.23, 95% CI: 1.02 to 1.50, p < 0.05). Levels of PTX3 at the coronary sinus were significantly higher than at the aortic root in HFNEF patients (p < 0.05) and in non-HF patients with LVDD (p < 0.01), but not different in non-HF patients without LVDD (p = 0.33). Conclusions Pentraxin 3 is significantly elevated in HFNEF patients and produced in the coronary circulation in patients with LVDD. Pentraxin 3, but not high-sensitivity CRP, is an independent inflammatory marker correlated with the presence of LVDD and HFNEF. (The Clinical Significance of Plasma Pentraxin 3 levels for Patients with Diastolic Heart Failure; UMIN000002170 )
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2010.10.018