Abstract 3561: Relation of Serum Heat Shock Protein 60 Level to Severity and Prognosis in Chronic Heart Failure
Background: Heat shock proteins 60 (Hsp 60) are induced by a variety of stressors including anoxia, oxidative stress, and inflammatory and have a protective role against stress-induced cardiomyocyte injury. Recently, it has been reported that Hsp 60 exists in the circulation and Hsp 60 levels are positively associated with TNF-α levels. Chronic heart failure (CHF) is characterized by systemic abnormalities and the myocardium is continually exposed to various stressors. However, clinical significance of serum Hsp 60 has not been examined in CHF. The purpose of this study was to examine whether:
Hsp 60 is correlated with the severity of CHF; and
Hsp 60 can predict clinical outcomes of CHF patients.
Methods and Results: Serum Hsp 60 level was measured in 199 CHF patients and 62 control subjects. Patients were prospectively followed with endpoints of cardiac death or re-hospitalization. Serum Hsp 60 level was higher in CHF patients than in control subjects and increased with advancing NYHA functional class (Fig. A⇓). There were 66 cardiac events during a follow-up period. Serum Hsp 60 level was higher in patients with cardiac events than in event-free patients. Patients were divided into 4 groups based upon Hsp 60 level. Cox proportional-hazards regression analysis revealed that the 4th quartile was associated with the highest risk of cardiac events compared with 1st quartile (hazard ratio 6.72). Kaplan-Meier analysis demonstrated that 4th quartile patients had a significantly higher cardiac event rates than other three quartiles patients (Fig. B⇓).
Conclusion: Serum Hsp 60 level was related to severity of CHF and associated with a high risk for adverse cardiac events in CHF patients.