Abstract 14463: Elevated Bone Marrow Derived Stromal Cell Derived Factor-1 Is Associated With Mortality in Heart Failure
Background: Bone marrow-derived cells are functionally exhausted in patients with chronic heart failure. We hypothesized that chronic heart failure is associated with impairment of the bone marrow niche. Stromal cell derived factor-1 (SDF-1) is an essential regulator of bone marrow cell function. Therefore, we evaluated whether bone marrow derived SDF-1 is associated with prognosis in patients with chronic heart failure.
Methods and Results: SDF-1 levels were determined in bone marrow plasma of 188 patients with chronic heart failure, who were enrolled in the Frankfurt Bone Marrow-Derived Cell Therapy Registry. Within a 5-year follow-up period 52 patients died. In a sub-cohort of 50 patients we further evaluated SDF-1 levels determined in peripheral blood samples.
Bone marrow plasma and peripheral blood SDF-1 levels were closely correlated (r=0.6, p<0.001). SDF-1 levels in bone marrow plasma were almost twice as high as in peripheral blood. Bone marrow SDF-1 levels were inversely correlated with left ventricular ejection fraction (LVEF; r=-0.2, p=0.01) and positively associated with the determinants of disease severity such as NT-proBNP (r=0.2, p=0.01) or hs-cTn T (r=0.3, p=0.004). Furthermore, SDF-1 bone marrow levels were negatively associated with bone marrow CD45+CD34+CD133+ cells. Patients with increased bone marrow-derived SDF-1 had a 1.37-fold increased risk for death (95%CI: 1.1 to 1.72, p=0.006). This association was robust, even after adjustment for clinical predictors of death in heart failure, such as age, sex, LVEF (HR:1.3, 95%CI: 1.0 to 1.7, p=0.049) or the SHFM score (HR:1.47, 95%CI: 1.08 to 2.01, p=0.015).
Conclusions: The present study discloses, for the first time, that bone marrow derived SDF-1 levels are independently associated with mortality in patients with chronic heart failure. These data further corroborate the importance of the bone marrow in patients with chronic heart failure to predict clinical outcome.
Author Disclosures: K. Sopova: None. B. von Jeinsen: None. L. Palapies: None. K. Stellos: None. S. Fichtlscherer: None. F. Seeger: None. S. Dimmeler: None. B. Assmus: None. A. Zeiher: None. T. Keller: None.
- © 2016 by American Heart Association, Inc.