Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction
Background: Patients with heart failure (HF) with improved ejection fraction (HFimpEF) demonstrate better clinical outcomes when compared with individuals without restoration of cardiac function. The identification of predictors for HFimpEF may play a crucial role in the individual management of HF...
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MDPI AG
2024-10-01
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| Series: | Cardiogenetics |
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| Online Access: | https://www.mdpi.com/2035-8148/14/4/14 |
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| author | Tetiana Berezina Oleksandr O. Berezin Michael Lichtenauer Alexander E. Berezin |
| author_facet | Tetiana Berezina Oleksandr O. Berezin Michael Lichtenauer Alexander E. Berezin |
| author_sort | Tetiana Berezina |
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| description | Background: Patients with heart failure (HF) with improved ejection fraction (HFimpEF) demonstrate better clinical outcomes when compared with individuals without restoration of cardiac function. The identification of predictors for HFimpEF may play a crucial role in the individual management of HF with reduced ejection fraction (HFrEF). Cell-free nuclear (cf-nDNA) DNA is released from damaged cells and contributes to impaired cardiac structure and function and inflammation. The purpose of the study was to elucidate whether cf-nDNA is associated with HFimpEF. Methods: The study prescreened 1416 patients with HF using a local database. Between October 2021 and August 2022, we included 452 patients with chronic HFrEF after prescription of optimal guideline-based therapy and identified 177 HFimpEF individuals. Circulating biomarkers were measured at baseline and after 6 months. Detection of cf-nDNA was executed with real-time quantitative PCR (qPCR) using NADH dehydrogenase, ND2, and beta-2-microglobulin. Results: We found that HFimpEF was associated with a significant decrease in the levels of cf-nDNA when compared with the patients from persistent HFrEF cohort. The presence of ischemia-induced cardiomyopathy (odds ration [OR] = 0.75; <i>p</i> = 0.044), type 2 diabetes mellitus (OR = 0.77; <i>p</i> = 0.042), and digoxin administration (OR = 0.85; <i>p</i> = 0.042) were negative factors for HFimpEF, whereas NT-proBNP ≤ 1940 pmol/mL (OR = 1.42, <i>p</i> = 0.001), relative decrease in NT-proBNP levels (>35% vs. ≤35%) from baseline (OR = 1.52; <i>p</i> = 0.001), and cf-nDNA ≤ 7.5 μmol/L (OR = 1.56; <i>p</i> = 0.001) were positive predictors for HFimpEF. Conclusions: We established that the levels of cf-nDNA ≤ 7.5 μmol/L independently predicted HFimpEF and improved the discriminative ability of ischemia-induced cardiomyopathy, IV NYHA class, and single-measured NT-proBNP and led to a relative decrease in NT-proBNP levels ≤35% from baseline in individuals with HFrEF. |
| format | Article |
| id | doaj-art-052c9ef5a0a34bd4a0cefd03a3e59793 |
| institution | DOAJ |
| issn | 2035-8253 2035-8148 |
| language | English |
| publishDate | 2024-10-01 |
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| series | Cardiogenetics |
| spelling | doaj-art-052c9ef5a0a34bd4a0cefd03a3e597932025-08-20T02:53:19ZengMDPI AGCardiogenetics2035-82532035-81482024-10-0114418319710.3390/cardiogenetics14040014Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection FractionTetiana Berezina0Oleksandr O. Berezin1Michael Lichtenauer2Alexander E. Berezin3Department of Internal Medicine and Nephrology, Vita Center, 69000 Zaporozhye, UkraineDepartment of Alter Psychiatrie, Luzerner Psychiatrie AG, 4915 St. Urban, SwitzerlandDivision of Cardiology, Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, AustriaDivision of Cardiology, Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, AustriaBackground: Patients with heart failure (HF) with improved ejection fraction (HFimpEF) demonstrate better clinical outcomes when compared with individuals without restoration of cardiac function. The identification of predictors for HFimpEF may play a crucial role in the individual management of HF with reduced ejection fraction (HFrEF). Cell-free nuclear (cf-nDNA) DNA is released from damaged cells and contributes to impaired cardiac structure and function and inflammation. The purpose of the study was to elucidate whether cf-nDNA is associated with HFimpEF. Methods: The study prescreened 1416 patients with HF using a local database. Between October 2021 and August 2022, we included 452 patients with chronic HFrEF after prescription of optimal guideline-based therapy and identified 177 HFimpEF individuals. Circulating biomarkers were measured at baseline and after 6 months. Detection of cf-nDNA was executed with real-time quantitative PCR (qPCR) using NADH dehydrogenase, ND2, and beta-2-microglobulin. Results: We found that HFimpEF was associated with a significant decrease in the levels of cf-nDNA when compared with the patients from persistent HFrEF cohort. The presence of ischemia-induced cardiomyopathy (odds ration [OR] = 0.75; <i>p</i> = 0.044), type 2 diabetes mellitus (OR = 0.77; <i>p</i> = 0.042), and digoxin administration (OR = 0.85; <i>p</i> = 0.042) were negative factors for HFimpEF, whereas NT-proBNP ≤ 1940 pmol/mL (OR = 1.42, <i>p</i> = 0.001), relative decrease in NT-proBNP levels (>35% vs. ≤35%) from baseline (OR = 1.52; <i>p</i> = 0.001), and cf-nDNA ≤ 7.5 μmol/L (OR = 1.56; <i>p</i> = 0.001) were positive predictors for HFimpEF. Conclusions: We established that the levels of cf-nDNA ≤ 7.5 μmol/L independently predicted HFimpEF and improved the discriminative ability of ischemia-induced cardiomyopathy, IV NYHA class, and single-measured NT-proBNP and led to a relative decrease in NT-proBNP levels ≤35% from baseline in individuals with HFrEF.https://www.mdpi.com/2035-8148/14/4/14heart failure with improved ejection fractionheart failure with reduced ejection fractioncell-free nuclear DNAbiomarkers |
| spellingShingle | Tetiana Berezina Oleksandr O. Berezin Michael Lichtenauer Alexander E. Berezin Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction Cardiogenetics heart failure with improved ejection fraction heart failure with reduced ejection fraction cell-free nuclear DNA biomarkers |
| title | Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction |
| title_full | Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction |
| title_fullStr | Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction |
| title_full_unstemmed | Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction |
| title_short | Circulating Cell-Free Nuclear DNA Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction |
| title_sort | circulating cell free nuclear dna predicted an improvement of systolic left ventricular function in individuals with chronic heart failure with reduced ejection fraction |
| topic | heart failure with improved ejection fraction heart failure with reduced ejection fraction cell-free nuclear DNA biomarkers |
| url | https://www.mdpi.com/2035-8148/14/4/14 |
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