van den Berg P F, Yousif L I, Markousis-Mavrogenis G, Shi C, Bracun V, Tromp J, de Wit S, Appels Y, Screever E M, Aboumsallem J P, Ouwerkerk W, van Veldhuisen D J, Silljé H H W, Voors A A, de Boer R A, Meijers Wouter C
Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands.
Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, Rotterdam, The Netherlands.
Cardiooncology. 2024 Aug 5;10(1):47. doi: 10.1186/s40959-024-00246-w.
Within cardio-oncology, emerging epidemiologic studies have demonstrated a bi-directional relationship between heart failure (HF) and cancer. In the current study, we aimed to further explore this relationship and investigate the underlying pathophysiological pathways that connect these two disease entities.
We conducted a post-hoc analysis in which we identified 24 Gene Ontology (GO) processes associated with the hallmarks of cancer based on 92 biomarkers in 1960 patients with HF. We performed Spearman's correlations and Cox-regression analyses to evaluate associations with HF biomarkers, severity and all-cause mortality.
Out of a total of 24 GO processes, 9 biological processes were significantly associated with adverse clinical outcome. Positive regulation of mononuclear cell proliferation demonstrated the highest hazard for reaching the clinical endpoint, even after adjusting for confounders: all-cause mortality HR 2.00 (95% CI 1.17-3.42), p = 0.012. In contrast, negative regulation of apoptotic process was consistently associated with a lower hazard of reaching the clinical outcome, even after adjusting for confounders: all-cause mortality HR 0.74 (95% CI 0.59-0.95), p = 0.016. All processes significantly correlated with HF biomarkers, renal function and HF severity.
In patients with HF, GO processes associated with hallmarks of cancer are associated with HF biomarkers, severity and all-cause mortality.
在心脏肿瘤学领域，新出现的流行病学研究已证实心力衰竭（HF）与癌症之间存在双向关系。在本研究中，我们旨在进一步探究这种关系，并调查连接这两种疾病实体的潜在病理生理途径。
我们进行了一项事后分析，基于1960例HF患者的92种生物标志物，确定了24个与癌症特征相关的基因本体（GO）过程。我们进行了Spearman相关性分析和Cox回归分析，以评估与HF生物标志物、严重程度和全因死亡率的关联。
在总共24个GO过程中，9个生物学过程与不良临床结局显著相关。即使在调整混杂因素后，单核细胞增殖的正调控显示达到临床终点的风险最高：全因死亡率HR为2.00（95%CI为1.17 - 3.42），p = 0.012。相比之下，即使在调整混杂因素后，凋亡过程的负调控始终与达到临床结局的较低风险相关：全因死亡率HR为0.74（95%CI为0.59 - 0.95），p = 0.016。所有过程均与HF生物标志物、肾功能和HF严重程度显著相关。
在HF患者中，与癌症特征相关的GO过程与HF生物标志物、严重程度和全因死亡率相关。
