Increased Transforming Growth Factor-β Levels Associated With Cardiac Adverse Events in Hypertrophic Cardiomyopathy - PubMed (original) (raw)

Increased Transforming Growth Factor-β Levels Associated With Cardiac Adverse Events in Hypertrophic Cardiomyopathy

Burak Ayça et al. Clin Cardiol. 2015 Jun.

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease characterized by ventricular hypertrophy, myocardial fibrosis, and impaired ventricular relaxation. The exact mechanisms by which fibrosis is caused remain unknown.

Hypothesis: Circulating TGF-β is related to poor prognosis in HCM.

Methods: We compared TGF-β levels of 49 HCM patients with those of 40 non-HCM patients. We followed the patients with HCM for 18 months and divided them into 2 groups: low TGF-β (≤ 4877 pg/mL) and high TGF-β (> 4877 pg/mL). We compared the 2 groups in terms of brain natriuretic peptide (BNP), echocardiographic parameters, and clinical outcomes including myocardial infarction, arrhythmias, implantable cardioverter-defibrillator implantation, hospitalization, New York Heart Association (NYHA) class, acute heart failure, and mortality.

Results: The HCM patients had higher TGF-β levels than those in the control group (P = 0.005). In the follow-up, those in the high TGF-β group had higher BNP levels, larger left-atrial size, thicker interventricular septum, NYHA class, more hospitalizations, and a greater number of clinical adverse events (P < 0.001, P = 0.01, P < 0.001, P = 0.002, P < 0.001 and P = 0.003, respectively). TGF-β level of > 4877 pg/mL can predict adverse events with a specificity of 75% and a sensitivity of 72% (P = 0.014). In multivariate regression analysis, TGF-β, BNP, and interventricular septum thickness were significantly associated with adverse events (P = 0.028, P = 0.030, and P = 0.034, respectively).

Conclusions: The TGF-β level is higher in HCM patients and associated with a poor prognosis in HCM.

© 2015 Wiley Periodicals, Inc.

PubMed Disclaimer

Figures

Figure 1

Figure 1

In the ROC curve analysis, TGF‐β levels >4877 pg/mL had a sensitivity of 71% and specificity of 75% in predicting adverse events in HCM patients (area under curve: 0.727, 95% CI: 0.567–0.887,

P

= 0.014). Abbreviations: CI, confidence interval; HCM, hypertrophic cardiomyopathy; ROC, receiver operating characteristic; TGF‐β, transforming growth factor‐β.

Figure 2

Figure 2

In the Kaplan‐Meier curve, the rate of cardiac adverse events was significantly higher in the high TGF‐β subgroup compared with the low TGF‐β subgroup (log‐rank

P

< 0.01). Abbreviations: TGF‐β, transforming growth factor‐β.

Similar articles

Cited by

References

    1. Maskatia SA. Hypertrophic cardiomyopathy: infants, children, and adolescents. Congenit Heart Dis. 2012;7:84–92. - PubMed
    1. Amano Y, Takeda M, Tachi M, et al. Myocardial fibrosis evaluated by Look‐Locker and late gadolinium enhancement magnetic resonance imaging in apical hypertrophic cardiomyopathy: association with ventricular tachyarrhythmia and risk factors. J Magn Reson Imaging. 2014;40:407–412. - PubMed
    1. Subasic K. Living with hypertrophic cardiomyopathy. J Nurs Scholarsh. 2013;45:371–379. - PubMed
    1. Hernández‐Romero D, Orenes‐Piñero E, García‐Honrubia A, et al. Involvement of the –420C > G RETN polymorphism in myocardial fibrosis in patients with hypertrophic cardiomyopathy. J Intern Med. 2014. doi:10.1111/joim.12334. - DOI - PubMed
    1. Brouwer WP, van Dijk SJ, Stienen GJ, et al. The development of familial hypertrophic cardiomyopathy: from mutation to bedside. Eur J Clin Invest. 2011;41:568–578. - PubMed

MeSH terms

Substances

LinkOut - more resources