New prognostic markers for patients with heart failure
New prognostic markers for patients with heart failure
Scientists from the Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV) (Spain) have advanced in the study of prognostic markers of heart failure, a progressive disease and a public health problem of first level. Specifically, they have studied the counting and distribution of monocytes-a type of white blood cell-in patients with heart failure to show their predictive role in a cohort of 400 outpatients.
The study, conducted at the Germans Trias i Pujol Research Institute (IGTP) and led by Antoni Bayés Genís, has been published in the journal PLoS One.
Monocytes are a heterogeneous population of blood effector cells with key functions in processes of repair and maintenance of the integrity of our tissues. It has been shown that there are three subsets of monocytes called classical (CD14 ++ / CD16-), intermediate (CD14 ++ / CD16 +) and non-classical (CD14 + / CD16 ++). Some studies have already indicated the existence of an association between some of these subpopulations of monocytes and cardiovascular events in different pathologies.
The purpose was to explore the distribution of the three subsets of monocytes, see if this is related to the events studied and, therefore, demonstrate if any of the three subpopulations of monocytes play a predictive role. To this end, a cohort of 400 outpatients diagnosed with heart failure was studied.
Researchers of the CIBERCV group. (Photo: IGTP)
As a result, a significant difference was found in the percentages of subsets of monocytes in relation to previous studies performed in healthy controls. In particular, the predominant subset of monocytes was the classical subset (50.0 ± 17.2%), followed by the intermediate (42 ± 17.2%); the non-classical subset of monocytes was represented much less frequently (8.1 ± 4.0%).
These levels suggest a significant increase in the intermediate monocyte subset in patients with heart failure compared to healthy subjects. Likewise, the quantification of the absolute cell count of each of the subsets of monocytes (number of cells / μL) showed a higher prognostic value for the cohort of patients studied, compared to the analysis of monocyte subsets by percentages.
In conclusion, argues Antoni Bayés Genís, "more studies are needed to confirm our findings and better interpret their clinical value, although we believe that we are closer to new and better prognostic markers of the disease."
Finally, it should be noted that the multivariate analysis showed that the subset of intermediate monocytes is associated independently with the main event of death from any cause and the combination of death from any cause and hospitalization due to heart failure.
Santiago Roura, co-author of the study, points out that "the persistence of this type of proinflammatory monocytes, beyond the initial phases of repair, could extend the adverse effects related to long-term inflammation to healthy remote areas of the heart of these patients. This could be a possible explanation for the worse prognosis that supposes to have higher levels of intermediate monocytes ".
Heart failure is a progressive disease and a public health problem of first level that imposes significant health, social and economic burdens. In developed countries, it affects 1-2% of the adult population, increasing in those over 70 to 8-10%. In fact, in this age group it is the first cause of hospitalization.
It is thought that a better stratification of risk through a better understanding of the underlying pathogenic mechanisms of this pathology, and new prognostic markers could be key in determining which patients would benefit from more strict follow-up or more aggressive treatment. (Source: CIBER)
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