Abstract 11007: Decreased Serum Brain-Derived Neurotrophic Factor Levels are Associated With Exercise Intolerance in Patients With Heart Failure
Background: Exercise intolerance as well as depressive symptoms are prevalent and associated with adverse outcomes in patients with heart failure (HF). They also impair the activities of daily living and quality of life (QOL) in patients with HF. Brain-derived neurotrophic factor (BDNF) is a member of neurotrophin family, which has been shown to be involved in skeletal muscle energy metabolism and depression. We thus investigated whether serum BDNF levels were associated with exercise capacity, cardiac dysfunction, and depressive symptoms among HF patients.
Methods and Results: Forty three consecutive patients with mild to moderate HF (33 men and 10 women, 57±15 years, New York Heart Association class I-III, left ventricular ejection fraction 33±12%) and 27 age-matched healthy subjects as controls (23 men and 4 women, 52±9 years) were studied. Causes of HF were ischemic in 28% and non-ischemic in 72%. Serum BDNF levels were significantly lower in HF patients than controls (18±5 vs. 25±6 ng/mL, P<0.01). Peak oxygen uptake (VO2) and anaerobic threshold (AT), evaluated by cardiopulmonary exercise test, were significantly lower in HF patients (peak VO2 14±3 vs. 29±7 ml/kg/min, P<0.01 and AT 9±2 vs. 15±4 ml/kg/min, P<0.01). Minnesota Living with HF (MLHF) questionnaire (>23) and Beck Depression Inventory (BDI)-II (≧14) scores were significantly higher in HF patients (MLHF 0 vs. 71%, P<0.05 and BDI-II 0 vs. 26%, P<0.05). By univariate analysis, serum BDNF levels were significantly correlated with peak VO2 (r=0.372, P<0.05), AT (r=0.324, P<0.05), and triglyceride (r=0.455, P<0.01) among HF patients. There was no significant association between serum BDNF levels and cardiac function or depressive symptoms, or QOL. By multivariate analysis, peak VO2 was identified as an independent determinant of serum BDNF levels (β-coefficient=5.03, 95%CI [1.64, 8.42], P<0.01).
Conclusion: Decreased serum BDNF levels were significantly associated with lowered exercise capacity in HF patients. Our present observations shed new light on the potential role of BDNF in the development of exercise intolerance seen in HF. Serum BDNF level may be a useful biomarker for predicting exercise intolerance and a potential therapeutic target for exercise training in HF.
- © 2013 by American Heart Association, Inc.