Abstract 2427: Prentraxin 3 is a Clinically Significant Inflammatory Marker Associated with Diastolic Heart Failure
Background: Pentraxin 3 (PTX3) is a newly identified pentraxin superfamily member including C-reactive protein (CRP) and rapidly increases by inflammatory stimuli. Chronic Heart failure (CHF) is a systemic disorder that affects not only cardiovascular but also systemic inflammation. The relationship between PTX3 levels and CHF with left ventricular (LV) diastolic dysfunction has been unknown. We investigated clinical significance of PTX3 levels in CHF patients with LV diastolic dysfunction.
Methods: We measured the plasma levels of PTX3, high-sensitivity CRP (hsCRP) and B-type natriuretic peptide (BNP) in 27 stable CHF patients with diastolic dysfunction (LV ejection fraction [LVEF] >50%, E/e’>12, E/A<0.9: age; 73.0 ± 8.1, male; 51.9%, ischemic cause; 48.1%) and 60 control subjects (age; 70.1 ± 8.2, male; 56.7%). We measured PTX3 levels at aortic root (Ao) and coronary sinus (CS) in 19 patients who received coronary angiography in control subjects.
Results: The levels of PTX3 and BNP, but not hsCRP, were significantly higher in CHF patients with LV diastolic dysfunction than control (PTX3; 3.48 [2.02 to 4.71] vs. 2.04 [1.61 to 2.84] ng/ml, p<0.01, BNP; 72.4 [31.0 to 170.8] vs. 37.2 [19.9 to 64.1] pg/ml, p<0.01, hsCRP; 1.10 [0.33 to 1.83] vs. 0.65 [0.25 to 1.65] mg/l, p=0.28). PTX3 levels at CS were significantly higher than those at Ao in the control patients with abnormality in LV diastolic properties (E/e’>12, E/A<0.9: n = 10, CS; 2.62 ± 1.41, Ao; 2.33 ± 1.34 ng/ml, p<0.01), but not significantly different in the control patients without LV diastolic dysfunction (n = 9, CS; 2.68 ± 1.10, Ao; 2.72 ± 1.30 ng/ml, p=0.71). Multiple logistic regression analysis demonstrated that the higher levels of PTX3, but not hsCRP, were significantly and independently contributed to the CHF with LV diastolic dysfunction (odds ratio 2.03, 95% confidence interval 1.22 to 3.37, p<0.01), adjusted with age, gender, hypertension, diabetes mellitus, dyslipidemia, LVEF and estimated glomerular filtration rate.
Conclusion: PTX3 is produced in the coronary circulation in patients with LV diastolic dysfunction and significantly elevated in CHF patients with LV diastolic dysfunction. PTX3, but not hsCRP, is a clinically useful inflammatory marker for CHF with LV diastolic dysfunction.