University of Groningen, Department of Cardiology, UMC Groningen, the Netherlands.
Novo Nordisk, Copenhagen, Denmark.
Int J Cardiol. 2024 Dec 15;417:132580. doi: 10.1016/j.ijcard.2024.132580. Epub 2024 Sep 19.
Chronic kidney disease (CKD) is prevalent and related to poor clinical outcomes in patients with heart failure (HF). The pathophysiology of CKD in HF with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF) is not well defined. In this study we compared clinical and proteomic profiles of CKD between patients with HFrEF and HFpEF.
We included 478 patients of the Scottish BIOSTAT-CHF cohort, of which 246 had HFrEF and 232 had HFpEF. CKD was defined as an eGFR <60 mL/min/1.73m. We compared HFrEF-patients with CKD to HFpEF-patients with CKD using logistic- and Cox-regression. We performed a differential expression analysis using 6376 proteins.
The prevalence of CKD was 36 % and 32 % in patients with HFpEF and HFrEF, respectively. CKD patients were on average 7 years older. BMI, higher NT-proBNP, ACE-inhibitors, HDL-cholesterol and Stroke were associated with CKD- patients with HFrEF. In HFpEF, CKD was associated with MRA-use and higher platelet count. CKD was associated with increased risk of death or heart failure hospitalization (HR 1.82, p < 0.001), with similar effect in HFrEF and HFpEF. The pattern of differentially expressed proteins between patients with and without CKD was similar in both HF-groups.
Clinical profiles related to CKD- patients with HFrEF were different from CKD-patients with HFrEF. CKD was associated with an increased risk of death or heart failure hospitalization, which was not different between HFpEF and HFrEF. Patterns of circulating proteins were similar between CKD-patients with HFpEF and HFrEF, suggesting no major differences in CKD-pathophysiology.
慢性肾脏病（CKD）在心力衰竭（HF）患者中较为常见，与不良临床结局相关。射血分数降低的心力衰竭（HFrEF）和射血分数保留的心力衰竭（HFpEF）患者的 CKD 病理生理学尚不清楚。本研究比较了 HFrEF 和 HFpEF 患者 CKD 的临床和蛋白质组学特征。
我们纳入了苏格兰 BIOSTAT-CHF 队列的 478 名患者，其中 246 名患者为 HFrEF，232 名患者为 HFpEF。CKD 的定义为 eGFR<60 mL/min/1.73m。我们使用逻辑回归和 Cox 回归比较了 HFrEF 合并 CKD 患者与 HFpEF 合并 CKD 患者。我们使用 6376 种蛋白质进行了差异表达分析。
HFpEF 和 HFrEF 患者中 CKD 的患病率分别为 36%和 32%。CKD 患者的平均年龄大 7 岁。BMI、更高的 NT-proBNP、ACE 抑制剂、HDL 胆固醇和中风与 HFrEF 患者的 CKD 相关。在 HFpEF 中，CKD 与 MRA 应用和更高的血小板计数相关。CKD 与死亡或心力衰竭住院风险增加相关（HR 1.82，p<0.001），在 HFrEF 和 HFpEF 中具有相似的效果。有或无 CKD 的患者之间差异表达蛋白的模式在两个 HF 组中相似。
与 HFrEF 患者 CKD 相关的临床特征与 HFrEF 患者 CKD 不同。CKD 与死亡或心力衰竭住院风险增加相关，HFpEF 和 HFrEF 之间无差异。HFpEF 和 HFrEF 合并 CKD 的患者的循环蛋白模式相似，提示 CKD 病理生理学无重大差异。
