Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy.
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy.
Biomolecules. 2020 Nov 23;10(11):1590. doi: 10.3390/biom10111590.
Heart Failure (HF) is a syndrome, which implies the existence of different phenotypes. The new categorization includes patients with preserved ejection fraction (HFpEF), mid-range EF (HFmrEF), and reduced EF (HFrEF) but the molecular mechanisms involved in these HF phenotypes have not yet been exhaustively investigated. Sirt1 plays a crucial role in biological processes strongly related to HF. This study aimed to evaluate whether Sirt1 activity was correlated with EF and other parameters in HFpEF, HFmrEF, and HFrEF. Seventy patients, HFpEF ( = 23), HFmrEF ( = 23) and HFrEF ( = 24), were enrolled at the Cardiology Unit of the University Hospital of Salerno. Sirt1 activity was measured in peripheral blood mononuclear cells (PBMCs). Angiotensin-Converting Enzyme 2 (ACE2) activity, Tumor Necrosis Factor-alpha (TNF-α) and Brain Natriuretic Peptide (BNP) levels were quantified in plasma. HFpEF showed lower Sirt1 and ACE2 activities than both HFmrEF and HFrEF ( < 0.0001), without difference compared to No HF controls. In HFmrEF and HFrEF a very strong correlation was found between Sirt1 activity and EF (r = 0.899 and r = 0.909, respectively), and between ACE2 activity and Sirt1 (r = 0.801 and r = 0.802, respectively). HFrEF showed the highest TNF-α levels without reaching statistical significance. Significant differences in BNP were found among the groups, with the highest levels in the HFrEF. Determining Sirt1 activity in PBMCs is useful to distinguish the HF patients' phenotypes from each other, especially HFmrEF/HFrEF from HFpEF.
心力衰竭（HF）是一种综合征，意味着存在不同的表型。新的分类包括射血分数保留的心力衰竭（HFpEF）、中间范围射血分数的心力衰竭（HFmrEF）和射血分数降低的心力衰竭（HFrEF），但这些心力衰竭表型中涉及的分子机制尚未得到充分研究。Sirt1 在与心力衰竭密切相关的生物学过程中起着至关重要的作用。本研究旨在评估 Sirt1 活性是否与 HFpEF、HFmrEF 和 HFrEF 中的 EF 和其他参数相关。在萨莱诺大学医院心内科共纳入 70 名患者，HFpEF（n=23）、HFmrEF（n=23）和 HFrEF（n=24）。外周血单核细胞（PBMCs）中测量 Sirt1 活性。在血浆中定量测定血管紧张素转换酶 2（ACE2）活性、肿瘤坏死因子-α（TNF-α）和脑钠肽（BNP）水平。HFpEF 的 Sirt1 和 ACE2 活性均低于 HFmrEF 和 HFrEF（<0.0001），与无心力衰竭对照组相比无差异。在 HFmrEF 和 HFrEF 中，Sirt1 活性与 EF 之间存在非常强的相关性（r=0.899 和 r=0.909），ACE2 活性与 Sirt1 之间也存在非常强的相关性（r=0.801 和 r=0.802）。HFrEF 显示出最高的 TNF-α 水平，但无统计学意义。各组间 BNP 存在显著差异，其中 HFrEF 组最高。在 PBMCs 中测定 Sirt1 活性有助于区分心力衰竭患者的表型，尤其是 HFmrEF/HFrEF 与 HFpEF。
