Circulating Endothelial-Derived Apoptotic Microparticles in the Patients with Ischemic Symptomatic Chronic Heart Failure: Relevance of Pro-Inflammatory Activation and Outcomes

Alexander  Berezin; Alexander A.  Kremzer; Tatayna A.  Samura; Yulia V.  Martovitskaya

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Circulating Endothelial-Derived Apoptotic Microparticles in the Patients with Ischemic Symptomatic Chronic Heart Failure: Relevance of Pro-Inflammatory Activation and Outcomes

Author(s):

Alexander Berezin^1,*,

Alexander A. Kremzer²,

Tatayna A. Samura²,

Yulia V. Martovitskaya³

1State Medical University, Internal Medicine Department, Zaporozhye, Ukraine

2State Medical University, Clinical Pharmacology Department, Zaporozhye, Ukraine

3State Medical University, Pathology Department, Zaporozhye, Ukraine

International Cardiovascular Research Journal:Vol. 8, issue 3; e11090

Published online:Sep 30, 2014

Article type:Research Article

Received:Feb 20, 2017

Accepted:Apr 30, 2014

How to Cite:Alexander BerezinAlexander A. KremzerTatayna A. SamuraYulia V. MartovitskayaCirculating Endothelial-Derived Apoptotic Microparticles in the Patients with Ischemic Symptomatic Chronic Heart Failure: Relevance of Pro-Inflammatory Activation and Outcomes.Int Cardiovasc Res J.8(3):e11090.

Abstract

Background: Endothelial-derived apoptotic microparticles (EMPs) play a pivotal role in endothelial dysfunction in hronic Heart Failure (CHF).

Objectives: The present study aimed to evaluate the association between EMPs and pro-inflammatory biomarkers, clinical status, and outcomes in the patients with ischemic CHF.

Patients and Methods: This study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF on discharge from hospital. The observation period was up to 3 years. Circulating NT-pro-BNP, TNF-alpha, sFas, and sFas ligand were determined at baseline. Flow cytometry analysis was used for quantifying the number of EMPs. All-cause mortality, CHF-related death, and CHD-re-hospitalization rate were examined. The data were analyzed using descriptive statistics, Receive Operation Characteristic Curve (ROC), and logistic regression analysis. Besides, P < 0.05 was considered as statistically significant.

Results: During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. The results showed a significant difference between the patients with a large number of EMPs (> 0.514 n/mL) and those with a low level of the biomarker (< 0.514 n/mL) regarding their survival. The number of circulating EPMs independently predicted all-cause mortality (OR = 1.58; 95% CI = 1.20 – 1.88; P = 0.001), CHF-related death (OR = 1.22; 95% CI: 1.12 – 1.36; P < 0.001), and CHF-related re-hospitalization (OR = 1.20; 95% CI: 1.11 – 1.32; P < 0.001).

Conclusions: Among the patients with symptoms of CHF, increased number of circulating EMPs was associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF.

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