Serum Markers of Neurodegeneration Are Strongly Linked to Heart Failure Severity and Outcome.
JACC Heart Fail
; 12(6): 1073-1085, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38839151
ABSTRACT
BACKGROUND:
Cognitive impairment is prevalent in patients with heart failure with reduced ejection fraction (HFrEF), affecting self-care and outcomes. Novel blood-based biomarkers have emerged as potential diagnostic tools for neurodegeneration.OBJECTIVES:
This study aimed to assess neurodegeneration in HFrEF by measuring neurofilament light chain (NfL), total tau (t-tau), amyloid beta 40 (Aß40), and amyloid beta 42 (Aß42) in a large, well-characterized cohort.METHODS:
The study included 470 patients with HFrEF from a biobank-linked prospective registry at the Medical University of Vienna. High-sensitivity single-molecule assays were used for measurement. Unplanned heart failure (HF) hospitalization and all-cause death were recorded as outcome parameters.RESULTS:
All markers, but not the Aß42Aß40 ratio, correlated with HF severity, ie, N-terminal pro-B-type natriuretic peptide and NYHA functional class, and comorbidity burden and were significantly associated with all-cause death and HF hospitalization (crude HR all-cause death NfL 4.44 [95% CI 3.02-6.53], t-tau 5.04 [95% CI 2.97-8.58], Aß40 3.90 [95% CI 2.27-6.72], and Aß42 5.14 [95% CI 2.84-9.32]; HF hospitalization NfL 2.48 [95% CI 1.60-3.85], t-tau 3.44 [95% CI 1.95-6.04], Aß40 3.13 [95% CI 1.84-5.34], and Aß42 3.48 [95% CI 1.93-6.27]; P < 0.001 for all). These associations remained statistically significant after multivariate adjustment including N-terminal pro-B-type natriuretic peptide. The discriminatory accuracy of NfL in predicting all-cause mortality was comparable to the well-established risk marker N-terminal pro-B-type natriuretic peptide (C-index 0.70 vs 0.72; P = 0.225), whereas the C-indices of t-tau, Aß40, Aß42, and the Aß42Aß40 ratio were significantly lower (P < 0.05 for all).CONCLUSIONS:
Neurodegeneration is directly interwoven with the progression of HF. Biomarkers of neurodegeneration, particularly NfL, may help identify patients potentially profiting from a comprehensive neurological work-up. Further research is necessary to test whether early diagnosis or optimized HFrEF treatment can preserve cognitive function.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fragmentos de Peptídeos
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Índice de Gravidade de Doença
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Biomarcadores
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Peptídeos beta-Amiloides
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Proteínas de Neurofilamentos
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Proteínas tau
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Insuficiência Cardíaca
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article