Abstract 10705: Elevated Levels of Hepatocyte Growth Factor and Interleukin-6 Distinguish Cardiac Amyloid From Non-Ischemic Cardiomyopathy as a Cause of Heart Failure
Introduction: Elevated levels of Hepatocyte Growth Factor (HGF) have rarely been observed in patients with systemic amyloidosis but little is known about HGF and other biomarkers in confirming the presence cardiac amyloid. Increased levels of Interleukin-6 (IL-6) correlates with worse prognosis in patients with heart failure but it is unknown if there is any diagnostic relationship in cardiac amyloidosis. Thus, biomarkers of angiogenesis (HGF) and inflammation (IL-6) may be useful in confirming cardiac amyloid and obviate the need for endomyocardial biopsy.
Hypothesis: Serum HGF and IL-6 levels can discriminate patients with cardiac amyloidosis from those with heart failure from a non-ischemic cardiomyopathy.
Methods: Serum HGF, IL-6, and B-type Natriuretic Peptide (BNP) were measured and echocardiographic (echo) features were assessed in 11 patients with biopsy-proven cardiac amyloid and 34 patients with non-ischemic cardiomyopathy (NICM) enrolled in an outpatient registry.
Results: Cardiac amyloid patients were 61±11 years of age and predominantly male (83%) while those with NICM were 54±15 years old and 47% male. Echo features of the cardiac amyloid group compared to NICM revealed smaller end-systolic (32±7mm vs. 47±14mm) and end-diastolic (43±6mm vs. 59±14mm) dimensions and higher left ventricular ejection fractions (0.5±18 vs. 0.31±15), and they were less symptomatic by NYHA class, all p ≤ 0.01. No difference was noted in left atrial size, 46±5mm vs 46±10mm, respectively, between groups. The serum marker and NYHA class data are shown in Table 1; all data is mean (±SD).
Conclusions: HGF and IL-6 are markedly elevated in patients with cardiac amyloidosis and may help diagnose cardiac amyloidosis in patients with heart failure. These findings suggest that measurement of HGF and IL-6 can be confirmatory for the diagnosis of cardiac amyloid and may minimize the need for invasive or extensive testing.
- © 2011 by American Heart Association, Inc.