How Do Cardiovascular Biomarkers Behave in Patients with Severe Aortic Valve Stenosis with and without Echocardiographically Proven Pulmonary Hypertension?—A Retrospective Study of Biomarker Trends before and after Transcatheter Aortic Valve Replacement
Abstract
:1. Introduction
2. Material & Methods
2.1. Study Population
2.2. Transthoracic Echocardiography
2.3. TAVR Procedure
2.4. Biomarker Analysis
2.5. Statistical Analysis
3. Results
3.1. Study Cohort
3.2. Baseline Characteristics of the Study
3.3. Biomarker Concentrations
3.3.1. sST2
3.3.2. GDF-15
3.3.3. H-FABP
3.3.4. IGF-BP2
3.3.5. suPAR
3.4. AUROC Results
3.5. Binary Logistic Regression
4. Discussion
4.1. sST2
4.2. GDF-15
4.3. H-FABP
4.4. IGF-BP2
4.5. suPAR
5. Conclusions
6. Limitation
7. Outlook
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall Cohort n = 85 | sPAP < 40 mmHg n = 32 | sPAP ≥ 40 mmHg n = 53 | |||||
---|---|---|---|---|---|---|---|
Clinical Data | p-value | ||||||
Age (years)—mean ± SD | 82.34 | 5.41 | 81.50 | 5.48 | 83.25 | 5.09 | 0.140 |
Gender (male)—% (n) | 50.60 | (43) | 50.00 | (16) | 50.90 | (27) | 0.933 |
Weight (kg)—mean ± SD | 72.39 | 12.50 | 73.09 | 14.77 | 70.59 | 8.44 | 0.556 |
Height (cm)—mean ± SD | 165.75 | 8.07 | 165.14 | 9.19 | 166.75 | 6.02 | 0.518 |
BMI (kg/m2)—mean ± SD | 26.30 | 4.09 | 27.08 | 4.49 | 25.14 | 3.03 | 0.122 |
NYHA—median ± IQR | 3.00 | 0.75 | 3.00 | 1.00 | 3.00 | 1.00 | 0.624 |
STSScore—mean ± SD | 3.08 | 1.62 | 2.56 | 1.29 | 3.29 | 1.51 | 0.025 |
Concomitant Disease | p-value | ||||||
Diabetes mellitus—% (n) | 24.70 | (21) | 21.90 | (7) | 26.40 | (14) | 0.638 |
Arterial Hypertension—% (n) | 77.60 | (66) | 78.10 | (25) | 83.00 | (44) | 0.576 |
CVD—% (n) | 61.20 | (52) | 59.40 | (19) | 62.30 | (33) | 0.791 |
CVD—1 vessel—% (n) | 14.10 | (12) | 15.60 | (5) | 13.20 | (7) | 0.756 |
CVD—2 vessels—% (n) | 12.90 | (11) | 9.40 | (3) | 15.1 | (8) | 0.447 |
CVD—3 vessels—% (n) | 23.50 | (20) | 21.90 | (7) | 24.50 | (13) | 0.780 |
Myocardial infarction—% (n) | 4.70 | (4) | 3.10 | (1) | 5.70 | (3) | 0.593 |
Atrial fibrillation—% (n) | 32.90 | (28) | 12.50 | (4) | 45.30 | (24) | 0.002 |
Malignancy—% (n) | 22.40 | (19) | 21.90 | (7) | 22.60 | (12) | 0.943 |
Stroke—% (n) | 9.40 | (8) | 9.40 | (3) | 9.40 | (5) | 0.993 |
PAD—% (n) | 9.40 | (8) | 3.10 | (1) | 13.20 | (7) | 0.123 |
COPD—% (n) | 8.20 | (7) | 9.40 | (3) | 7.50 | (4) | 0.766 |
Pacemaker—% (n) | 3.50 | (3) | 0.00 | (0) | 5.70 | (3) | 0.171 |
Echocardiography | p-value | ||||||
LVEF (%)—mean ± SD | 53.42 | 9.99 | 55.25 | 6.17 | 52.00 | 11.50 | 0.099 |
LVEDD (mm)—mean ± SD | 4.69 | 0.61 | 4.63 | 0.71 | 4.66 | 0.53 | 0.838 |
IVSd (mm)—mean ± SD | 13.36 | 2.50 | 13.23 | 2.28 | 13.54 | 2.04 | 0.523 |
AV Vmax (m/s)—mean ± SD | 4.43 | 0.55 | 4.34 | 0.61 | 4.43 | 0.52 | 0.535 |
AV dPmean (mmHg)—mean ± SD | 49.55 | 11.52 | 46.55 | 11.39 | 50.61 | 11.83 | 0.147 |
AV dPmax (mmHg)—mean ± SD | 81.61 | 20.15 | 77.59 | 19.49 | 82.67 | 21.00 | 0.299 |
sPAP (mmHg)—mean ± SD | 46.36 | 17.49 | 31.75 | 6.86 | 54.42 | 15.10 | <0.001 |
TAPSE (mm)—mean ± SD | 22.25 | 3.78 | 23.12 | 3.21 | 20.95 | 4.06 | 0.017 |
AVI ≥ II—% (n) | 16.50 | (14) | 21.90 | (7) | 13.20 | (7) | 0.561 |
MVI ≥ II—% (n) | 41.20 | (35) | 34.40 | (11) | 45.30 | (24) | 0.304 |
TVI ≥ II—% (n) | 29.40 | (25) | 12.50 | (4) | 39.60 | (21) | 0.007 |
Laboratory data | p-value | ||||||
Creatinine (mg/dL)—median ± IQR | 1.00 | 0.37 | 0.95 | 0.30 | 1.10 | 0.50 | 0.002 |
BNP (pg/mL)—median ± IQR | 1599.50 | 3117.45 | 1122.50 | 1017.53 | 3162.00 | 4440.00 | 0.001 |
cTnI (pg/mL)—median ± IQR | 21.00 | 21.00 | 16.00 | 15.50 | 31.00 | 41.00 | 0.002 |
Hkt (%)—median ± IQR | 39.60 | 7.18 | 41.20 | 5.75 | 37.40 | 8.50 | 0.037 |
Hb (g/dL)—median ± IQR | 12.95 | 2.53 | 13.05 | 1.78 | 12.30 | 3.40 | 0.052 |
CK (U/L)—median ± IQR | 67.50 | 74.75 | 77.00 | 115.50 | 59.00 | 71.00 | 0.492 |
sPAP < 40 mmHg n = 32 | sPAP ≥ 40 mmHg n = 53 | ||||
---|---|---|---|---|---|
sST2 (pg/mL) | p-value | ||||
sST2 baseline—median ± IQR | 10,750.80 | 5894.78 | 16,134.67 | 13,351.82 | 0.007 |
sST2 24 h—median ± IQR | 14,220.25 | 11,628.33 | 17,372.76 | 13,826.10 | 0.006 |
sST2 96 h—median ± IQR | 9919.84 | 4239.27 | 13,217.80 | 8591.19 | 0.014 |
sST2 3 months—median ± IQR | 10,120.52 | 4258.88 | 10,671.73 | 7354.71 | <0.001 |
sST2 12 months—median ± IQR | 11,179.72 | 9233.51 | 12,142.09 | 10,029.74 | 0.092 |
GDF-15 (pg/mL) | p-value | ||||
GDF-15 baseline—median ± IQR | 541.45 | 763.12 | 777.43 | 857.02 | 0.075 |
GDF-15 24 h—median ± IQR | 692.60 | 843.94 | 1104.17 | 943.32 | 0.016 |
GDF-15 96 h—median ± IQR | 573.67 | 519.41 | 901.27 | 696.17 | 0.101 |
GDF-15 3 months—median ± IQR | 1055.32 | 920.54 | 1060.02 | 420.61 | 0.244 |
GDF-15 12 months—median ± IQR | 980.16 | 498.64 | 1095.39 | 445.38 | 0.090 |
H-FABP (ng/mL) | p-value | ||||
H-FABP baseline—median ± IQR | 0.00 | 0.51 | 1.50 | 2.86 | 0.022 |
H-FABP 24 h—median ± IQR | 0.00 | 1.48 | 1.48 | 2.77 | 0.012 |
H-FABP 96 h—median ± IQR | 0.09 | 1.05 | 0.87 | 3.40 | 0.037 |
H-FABP 3 months—median ± IQR | 0.34 | 1.41 | 1.28 | 2.07 | 0.006 |
H-FABP12 months—median ± IQR | 0.99 | 1.62 | 2.09 | 1.95 | 0.030 |
IGF-BP2 (pg/mL) | p-value | ||||
IGF-BP2 baseline—median ± IQR | 125,163.32 | 128,179.49 | 178,630.35 | 146,366.21 | 0.029 |
IGF-BP2 24 h—median ± IQR | 125,163.32 | 115,595.66 | 178,630.35 | 143,275.97 | 0.012 |
IGF-BP2 96 h—median ± IQR | 186,473.04 | 104,689.81 | 253,454.40 | 141,091.62 | 0.001 |
IGF-BP2 3 months—median ± IQR | 143,038.18 | 103,202.90 | 208,982.19 | 125,501.54 | 0.015 |
IGF-BP2 12 months—median ± IQR | 144,259.45 | 115,646.78 | 180,755.50 | 185,500.31 | 0.022 |
suPAR (pg/mL) | p-value | ||||
suPAR baseline—median ± IQR | 3322.47 | 1106.45 | 4180.44 | 2243.84 | 0.003 |
suPAR 24 h—median ± IQR | 3694.77 | 940.29 | 4045.97 | 2221.08 | 0.041 |
suPAR 96 h—median ± IQR | 3742.90 | 1813.56 | 4076.90 | 2396.88 | 0.127 |
suPAR 3 months—median ± IQR | 4553.73 | 2176.08 | 4469.58 | 2225.77 | 0.006 |
suPAR 12 months—median ± IQR | 4171.91 | 2364.61 | 4127.91 | 2706.40 | 0.477 |
sPAP ≥ 40 mmHg Binary Logistic Regression | Univariate | Multivariate | ||
---|---|---|---|---|
Hazard Ratio (95%) | p-Value | Hazard Ratio (95%) | p-Value | |
Age | 1.066 (0.978—1.161) | 0.145 | ||
Gender (male) | 0.963 (0.400—2.316) | 0.933 | ||
Weight | 0.980 (0.924—1.039) | 0.490 | ||
Height | 1.032 (0.940—1.133) | 0.507 | ||
BMI | 0.862 (0.709—1.048) | 0.135 | ||
NYHA | 1.756 (0.525—5.876) | 0.361 | ||
STSScore | 1.498 (1.038—2.163) | 0.031 | 1.357 (0.794—2.317) | 0.264 |
Diabetes mellitus | 1.282 (0.455—3.616) | 0.639 | ||
Arterial Hypertension | 1.369 (0.454—4.125) | 0.577 | ||
Cardiovascular Disease (all) | 1.129 (0.460—2.771) | 0.791 | ||
CVD—1 vessel | 0.822 (0.237—2.846) | 0.757 | ||
CVD—2 vessels | 1.719 (0.421—7.015) | 0.451 | ||
CVD—3 vessels | 1.161 (0.408—3.303) | 0.780 | ||
Myocardial infarction | 1.860 (0.185—18.684) | 0.598 | ||
Atrial fibrillation | 5.793 (1.782—18.834) | 0.003 | 9.361 (1.175—74.576) | 0.035 |
Malignancy | 1.045 (0.363—3.007) | 0.935 | ||
Stroke | 1.007 (0.224—4.530) | 0.993 | ||
PAD | 4.717 (0.553—40.265) | 0.156 | ||
COPD | 0.789 (0.165—3.777) | 0.767 | ||
LVEF | 0.963 (0.915—1.014) | 0.152 | ||
LVEDD | 1.085 (0.504—2.335) | 0.835 | ||
IVSd | 1.074 (0.864—1.335) | 0.518 | ||
AV Vmax | 1.323 (0.553—3.163) | 0.529 | ||
AV dPmean | 1.031 (0.989—1.075) | 0.149 | ||
AV dPmax | 1.013 (0.989—1.037) | 0.299 | ||
TAPSE | 0.853 (0.744—0.977) | 0.022 | 0.698 (0.529—0.922) | 0.011 |
AVI ≥ II | 0.696 (0.204—2.372) | 0.562 | ||
MVI ≥ II | 1.616 (0.645—4.049) | 0.306 | ||
TVI ≥ II | 4.725 (1.439—15.515) | 0.010 | 3.333 (0.616—18.020) | 0.162 |
Creatinine (baseline) | 2.548 (1.203—5.395) | 0.015 | 0.855 (0.187—3.902) | 0.839 |
BNP (baseline) | 8.402 (1.878—37.596) | 0.005 | 1.130 (0.146—8.738) | 0.907 |
cTnI (baseline) | 3.907 (1.018—14.998) | 0.047 | 0.852 (0.151—4.817) | 0.856 |
Hkt (baseline) | 1.144 (0.654—2.001) | 0.638 | ||
Hb (baseline) | 0.602 (0.374—0.969) | 0.037 | 1.833 (0.544—6.174) | 0.328 |
CK (baseline) | 1.036 (0.671—1.600) | 0.872 | ||
sST2 (baseline) | 2.080 (1.223—3.537) | 0.007 | 6.021 (1.793—20.219) | 0.004 |
GDF-15 (baseline) | 1.475 (0.901—2.414) | 0.122 | ||
H-FABP (baseline) | 2.964 (1.208—7.270) | 0.018 | 0.503 (0.081—3.120) | 0.460 |
IGF-BP2 (baseline) | 2.273 (0.955—5.413) | 0.064 | 1.799 (0.274—11.812) | 0.541 |
suPAR (baseline) | 1.518 (0.904—2.548) | 0.114 |
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Boxhammer, E.; Schmidbauer, L.; Mirna, M.; Paar, V.; Hammerer, M.; Hoppe, U.C.; Lichtenauer, M. How Do Cardiovascular Biomarkers Behave in Patients with Severe Aortic Valve Stenosis with and without Echocardiographically Proven Pulmonary Hypertension?—A Retrospective Study of Biomarker Trends before and after Transcatheter Aortic Valve Replacement. Appl. Sci. 2022, 12, 5765. https://doi.org/10.3390/app12125765
Boxhammer E, Schmidbauer L, Mirna M, Paar V, Hammerer M, Hoppe UC, Lichtenauer M. How Do Cardiovascular Biomarkers Behave in Patients with Severe Aortic Valve Stenosis with and without Echocardiographically Proven Pulmonary Hypertension?—A Retrospective Study of Biomarker Trends before and after Transcatheter Aortic Valve Replacement. Applied Sciences. 2022; 12(12):5765. https://doi.org/10.3390/app12125765
Chicago/Turabian StyleBoxhammer, Elke, Lukas Schmidbauer, Moritz Mirna, Vera Paar, Matthias Hammerer, Uta C. Hoppe, and Michael Lichtenauer. 2022. "How Do Cardiovascular Biomarkers Behave in Patients with Severe Aortic Valve Stenosis with and without Echocardiographically Proven Pulmonary Hypertension?—A Retrospective Study of Biomarker Trends before and after Transcatheter Aortic Valve Replacement" Applied Sciences 12, no. 12: 5765. https://doi.org/10.3390/app12125765