P639Osteopontin plasma level as a target in the assessment of severity heart failure and cardiac remodelling

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Abstract

Background

In some recently studies have been reported that osteopontin is dramatically increased in blood in patients with mild-to-severe of heart failure (HF), and it is associated with systemic inflammatory response.

Aim

To investigate interrelations between plasma level of osteopontin with both neurohumoral / proinflammatory activation and severity of cardiac remodeling in patients with mild-to-severe of HF.

Methods

Peripheral blood was collected from 64 patients with mild-to-severe HF due to ischemic heart disease and 30 healthy control subjects. Area of both left ventricle and left atrial were examined by Echo, mitral regurgitation was analyzed by Doppler. Left ventricular ejection fraction (LVEF) was calculated using a modified Simpson's rule. The 64 patients were classified into 3 classes according to the New York Heart Association (NYHA) functional classification. Osteopontin, tumor necrosis factor-alpha and NT-pro-brain natriuretic peptide in plasma were examined by ELISA.

Results

Plasma levels of osteopontin, tumor necrosis factor-alpha and NT-pro-brain natriuretic peptide were higher in patients with HF than in controls (p=0.012; p < 0.05 and p < 0.001). Furthermore, both the plasma osteopontin levels and NT-pro-brain natriuretic peptide increased in proportion to the severity of the NYHA functional class. Tumor necrosis factor-alpha in plasma is correlated well with NYHA functional class in patients with moderate-to-severe HF only (r=-0.380, p < 0.01). It this patients population tumor necrosis factor-alpha level was correlated with body mass index (r=-0.328, p=0.014) and LVEF (r=-0.388, p=0.0036). The osteopontin plasma level was significantly correlated with LVEF (r=-0.406, p=0.0022), mitral regurgitation (r=0.40, p < 0.05), area of both left ventricle and left atrial (r=0.402, p < 0.01 and r=0.406, p < 0.001), log plasma NT-pro-brain natriuretic peptide level (r=0.45, p=0.002), and tumor necrosis factor-alpha level (r=0.301, p=0.012). However, after adjustment to age, sex, body mass index and treatment regimes osteopontin plasma level had been preserved significant interrelationships with both severity of symptomatic HF and cardiac remodelling.

Results

In conclusions, osteopontin plasma level reflects the severity of symptomatic HF and correlates well with both LVEF and NT-pro-brain natriuretic peptide concentration. Osteopontin could be considered as target in the assessment of severity both HF and cardiac remodelling.

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