Abstract 12953: Serum Thrombospondin-2 Levels Correlate with Disease Severity and Predict Mortality in Patients with Heart Failure with Preserved Ejection Fraction
Introduction: Thrombospondin-2 (TSP-2) is a matricellular protein and its expression is increased in hypertensive heart. Interstitial fibrosis is frequently observed in hypertensive heart, and it is one of the histological characteristics of heart failure with preserved ejection fraction (HFpEF).
Hypothesis: TSP-2 reflects disease severity and predicts mortality in patients with HFpEF.
Methods and results: We measured serum TSP-2 levels in 129 patients with HFpEF. HFpEF was defined as an left ventricular ejection fraction equal or greater than 50%, BNP≧100pg/ml or E/e’≧15. Serum TSP-2 concentrations were measured by ELISA. The endpoints of this study were composed of total mortality, fatal arrhythmia, HF hospitalization, and stroke. These patients were divided into 2 groups according to the TSP-2 levels. Median TSP-2 levels in each group were 13.72 ng/ml and 24.93 ng/ml, respectively. High TSP-2 group showed significantly higher BNP [median 171.0, interquartile range (58.8-296.6) vs. 53.5, (19.5-96.6) pg/ml, p≤0.0001], mean pulmonary capillary wedge pressure [12.0, (9.0-15.0) vs. 9.0, (7.0-12.0) mg/l, p=0.002] than those with low TSP-2 group. Serum TSP-2 levels were positively correlated with NYHA functional class in this study population (p≤0.0001). Kaplan Meier curve revealed that the event-free rate was decreased in the high TSP-2 group (log-rank test p=0.005). Multiple Cox regression analysis identified NYHA (hazard ratio [HR]: 4.11; confidence interval [CI]: 1.66-10.22, p=0.002), diabetes mellitus (HR: 0.17; CI: 0.04-0.75, p=0.02), atrial fibrillation (HR: 4.78; CI: 1.48-15.39, p = 0.009), dyslipidemia (HR: 11.22; CI: 1.19-106.04, p = 0.02), and TSP-2 (HR: 7.38; CI: 2.30-23.67, p = 0.001) as independent predictors for primary end point.
Conclusions: Circulating TSP-2 correlates with disease severity in patients with HFpEF. TSP-2 could be a useful biomarker to predict future adverse cardiovascular events in patients with HFpEF.
- © 2013 by American Heart Association, Inc.