University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
University Medical Centre Ljubljana, Department of Vascular Diseases, Ljubljana, Slovenia.
Dis Markers. 2022 Oct 25;2022:9539676. doi: 10.1155/2022/9539676. eCollection 2022.
Heart failure with preserved ejection fraction (HFpEF) has a complex pathophysiology that encompasses systemic proinflammatory state and dysregulated levels of cardiometabolic and oxidative stress biomarkers. The prevalence of both HFpEF and atrial fibrillation (AF) is continuously rising, especially in the elderly. The aim of our study was to explore if there were any differences in biomarker levels and vascular function in the elderly patients with HFpEF with and without AF and to assess interconnections between clinically relevant biomarkers and cardiac and vascular function.
This was a cross-sectional study of patients ≥ 65 years with HFpEF who were divided into 2 groups based on the presence or absence of AF. We have sonographically assessed echocardiographic parameters of left ventricular systolic and diastolic function and the peripheral vascular function parameters, namely, pulse wave velocity (PWV) and flow-mediated dilation (FMD). NT-proBNP, irisin, leptin, adiponectin, insulin-like growth factor 1 (IGF-1), and malondialdehyde (MDA) blood levels were determined.
Fifty-two patients (mean age 80 ± 7 years, 67% females) were included. Patients with HFpEF and AF had significantly lower levels of irisin (median 4.75 vs. 13.5 ng/mL, = 0.007), leptin (median 9.5 vs. 15.0 ng/L, = 0.023), and MDA (median 293 vs. 450 ng/mL, = 0.017) and significantly higher values of NT-proBNP (median 2365 vs. 529 ng/L, < 0.001) but not vascular function parameters, as compared to HFpEF patients without AF. MDA was significantly correlated with diastolic function ( = 0.395, = 0.007) and FMD ( = 0.394, = 0.011), while adiponectin was inversely associated with FMD ( = -0.325, = 0.038) and left ventricular ejection fraction ( = -0.319, = 0.029).
Our results have demonstrated that patients with HFpEF and AF have significantly lower leptin, irisin, and MDA levels compared to patients with HFpEF but without AF. These results offer new insights into the complexity of vascular function and cardiometabolic and oxidative stress biomarkers in the context of HFpEF, AF, and aging.
射血分数保留的心力衰竭（HFpEF）具有复杂的病理生理学，包括全身促炎状态和代谢及氧化应激生物标志物水平失调。HFpEF 和心房颤动（AF）的患病率都在持续上升，尤其是在老年人中。我们的研究目的是探讨在伴有和不伴有 AF 的老年 HFpEF 患者中，生物标志物水平和血管功能是否存在差异，并评估临床相关生物标志物与心功能和血管功能之间的相互关系。
这是一项横断面研究，纳入了≥ 65 岁的 HFpEF 患者，根据是否存在 AF 将其分为两组。我们通过超声心动图评估了左心室收缩和舒张功能的参数以及外周血管功能参数，即脉搏波速度（PWV）和血流介导的扩张（FMD）。测定了 NT-proBNP、鸢尾素、瘦素、脂联素、胰岛素样生长因子 1（IGF-1）和丙二醛（MDA）的血液水平。
共纳入 52 例患者（平均年龄 80 ± 7 岁，67%为女性）。HFpEF 合并 AF 患者的鸢尾素（中位数 4.75 比 13.5ng/mL， = 0.007）、瘦素（中位数 9.5 比 15.0ng/L， = 0.023）和 MDA（中位数 293 比 450ng/mL， = 0.017）水平显著较低，而 NT-proBNP（中位数 2365 比 529ng/L， < 0.001）水平显著较高，但两组患者的血管功能参数无显著差异。MDA 与舒张功能（ = 0.395， = 0.007）和 FMD（ = 0.394， = 0.011）显著相关，而脂联素与 FMD（ = -0.325， = 0.038）和左心室射血分数（ = -0.319， = 0.029）呈负相关。
我们的研究结果表明，HFpEF 合并 AF 患者的瘦素、鸢尾素和 MDA 水平显著低于 HFpEF 但不伴有 AF 的患者。这些结果为 HFpEF、AF 和衰老背景下血管功能和代谢及氧化应激生物标志物的复杂性提供了新的见解。
