Abstract 16138: Prognostic Value of Lymphocyte G Protein-Coupled Receptor Kinase-2 (grk2) Protein Levels in Patients With Heart Failure
Background: Sympathetic nervous system (SNS) hyperactivity is associated with poor prognosis in patients with heart failure (HF), yet routine assessment of SNS activation is not recommended for clinical practice. Myocardial G-protein coupled receptor kinase-2 (GRK2) is up-regulated in HF patients, causing beta-adrenergic receptor signaling dysfunction. Importantly, myocardial GRK2 levels correlate with peripheral lymphocytes GRK2 levels in HF patients. However, the independent prognostic value of GRK2 measurement in HF patients has never been investigated. Thus, the purpose of the present study was to evaluate whether lymphocyte GRK2 levels predict clinical outcome in HF patients.
Methods: We prospectively studied 282 HF patients with mean left ventricular ejection fraction (LVEF) 32.6±10.3%. At the time of enrollment, plasma norepinephrine, serum NT-proBNP and lymphocyte GRK2 protein levels, as well as clinical and instrumental variables were measured. The prognostic value of GRK2 to predict cardiac death, all cause mortality and re-hospitalization due to cardiac reason was assessed using multivariate Cox proportional hazards regression analysis including demographic, clinical, instrumental and laboratory data.
Results: Over a mean follow-up period of 37.8±20.5 months (range: 3-60 months) there were 110 cardiac deaths. Age (HR=1.034;p=0.010), LVEF (HR=0.97;p=0.047), glomerular filtration rate (HR=0.593;p=0.013), NT-proBNP (HR=1.00;p=0.004) and lymphocyte GRK2 protein levels (HR=1.614;p=0.001) were independent predictors of cardiac mortality in HF patients, with incremental prognostic value over clinical variables, LVEF and NT-proBNP. The independent prognostic value of lymphocyte GRK2 levels was also confirmed for all cause mortality and re-hospitalization.
Conclusion: Lymphocyte GRK2 protein levels independently and incrementally predict prognosis in patients with HF.
- © 2013 by American Heart Association, Inc.