Abstract 17435: Gender Difference of Nerve Growth Factor Expression in Heart Failure Patients: Preliminary Results from a Single Centre Study
Introduction: Sympathetic nervous system plays a critical role in disease progression and cardiac risk after myocardial infarction and in chronic heart failure (CHF) patients. Cardiac remodeling after a heart attack is accompanied by a sprouting of cardiac nerves under the stimulus of the Nerve Growth Factor (NGF). Experimental evidences document elevated plasma NGF levels early after an ischemia. The nerve density of the failing heart tends to progressively decrease with heart dysfunction worsening as a consequence of NGF inhibition by high cathecolamines levels. So far no data exists on NGF plasma levels in stable CHF. Hypothesis: we hypothesized that NGF levels were reduced in CHF patients with depressed left ventricle ejection fraction (LVEF) with respect to a control group.
Methods: Between November 2010 and January 2012, 2 blood samples were drawn from patients with CHF and depressed LVEF (< 35%) followed in our Heart Failure Clinic. Clinical data from the study group was then compared with data obtained in a control group of healthy subjects matched for body mass index and heart rate.
Results: The study population consisted of 50 consecutive out-patients (mean age 69.6±9.6 years, male 81%) with reduced LVEF (mean 34.6±9%) and NYHA class II-III. The control group was constituted by 35 subjects (mean age 55.2±2.7, male 60%). Mean NGF in CHF patients was significantly lower with respect to the control group (71.4±3.8 ng/ml vs 88.6±4.6 ng/ml, p<0.005). This difference was primarily evident in men (cases 68.5 ± 4.0 ng/ml and controls 85.1 ± 5.9 ng/ml, p=0.02) with respect to women (cases 84.5 ± 31.8 ng/ml and controls 94 ± 21.8 ng/ml, p=NS). Furthermore, in the male population we observed 12 cases and no controls having NGF plasma level below 55 ng/ml (Fisher exact test p=0.05). A slight correlation between LVEF and NGF values was detected in the whole population (r2=0.33, p=0.05).
Conclusion: NGF plasma levels are significant lower in patients with CHF with respect to control subjects, with a slight positive correlation between NGF and LVEF, especially in men. Further larger trial are required to investigate NGF in heart failure and its potential modulation according to the gender of CHF patients.
- © 2012 by American Heart Association, Inc.