Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy

<b>Objectives</b>: This retrospective study examines midkine, an inflammatory cytokine, as a potential serological biomarker to distinguish dilated cardiomyopathy (DCM) and inflammatory dilated cardiomyopathy (DCMi). Identifying such a biomarker is crucial for effective treatment of thes...

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Main Authors: Ulrich Grabmaier, Bartolo Ferraro, Kristin Lehnert, Astrid Petersmann, Stephan B. Felix, Ludwig T. Weckbach
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/2/504
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author Ulrich Grabmaier
Bartolo Ferraro
Kristin Lehnert
Astrid Petersmann
Stephan B. Felix
Ludwig T. Weckbach
author_facet Ulrich Grabmaier
Bartolo Ferraro
Kristin Lehnert
Astrid Petersmann
Stephan B. Felix
Ludwig T. Weckbach
author_sort Ulrich Grabmaier
collection DOAJ
description <b>Objectives</b>: This retrospective study examines midkine, an inflammatory cytokine, as a potential serological biomarker to distinguish dilated cardiomyopathy (DCM) and inflammatory dilated cardiomyopathy (DCMi). Identifying such a biomarker is crucial for effective treatment of these two entities. <b>Methods</b>: The study included 54 patients with heart failure, reduced left ventricular systolic function, and suspected cardiac inflammation. Endomyocardial biopsies were obtained from all 54 patients to differentiate between DCM and DCMi. Blood sera were collected from these patients the same day the endomyocardial biopsy was performed and compared with those of 13 age-matched healthy individuals for different measurements such as midkine and NT-proBNP. Patients were followed up to a median of 194 days after the baseline visit. <b>Results</b>: Endomyocardial biopsies from patients with DCMi were associated with more infiltrating immune cells such as CD68<sup>+</sup> macrophages and CD3<sup>+</sup> T cells and a more frequent presence of a viral genome than those from patients with DCM. Both groups showed similar improvements in LV function and dimensions over time. MK serum levels were significantly higher in DCM/ DCMi patients than in healthy individuals but did not differ significantly between DCM and DCMi. MK levels did not significantly correlate with NYHA class, NT-proBNP, LVEDD, or LVEF, except for a weak correlation with LVEF at follow-up. <b>Conclusions</b>: Midkine serum levels were significantly higher in patients with a DCM phenotype and severely reduced systolic function. However, these levels could not distinguish between DCM and DCMi and showed no correlation with baseline or follow-up parameters. Therefore, midkine cannot be used as a biomarker to distinguish between DCM and DCMi.
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spelling doaj-art-3c560741c1904f2796a1d810f52a3a8b2025-08-20T02:44:45ZengMDPI AGBiomedicines2227-90592025-02-0113250410.3390/biomedicines13020504Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated CardiomyopathyUlrich Grabmaier0Bartolo Ferraro1Kristin Lehnert2Astrid Petersmann3Stephan B. Felix4Ludwig T. Weckbach5Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-University Hospital, 81377 Munich, GermanyMedizinische Klinik und Poliklinik I, Ludwig-Maximilians-University Hospital, 81377 Munich, GermanyDepartment of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, GermanyInstitute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, GermanyDepartment of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, GermanyMedizinische Klinik und Poliklinik I, Ludwig-Maximilians-University Hospital, 81377 Munich, Germany<b>Objectives</b>: This retrospective study examines midkine, an inflammatory cytokine, as a potential serological biomarker to distinguish dilated cardiomyopathy (DCM) and inflammatory dilated cardiomyopathy (DCMi). Identifying such a biomarker is crucial for effective treatment of these two entities. <b>Methods</b>: The study included 54 patients with heart failure, reduced left ventricular systolic function, and suspected cardiac inflammation. Endomyocardial biopsies were obtained from all 54 patients to differentiate between DCM and DCMi. Blood sera were collected from these patients the same day the endomyocardial biopsy was performed and compared with those of 13 age-matched healthy individuals for different measurements such as midkine and NT-proBNP. Patients were followed up to a median of 194 days after the baseline visit. <b>Results</b>: Endomyocardial biopsies from patients with DCMi were associated with more infiltrating immune cells such as CD68<sup>+</sup> macrophages and CD3<sup>+</sup> T cells and a more frequent presence of a viral genome than those from patients with DCM. Both groups showed similar improvements in LV function and dimensions over time. MK serum levels were significantly higher in DCM/ DCMi patients than in healthy individuals but did not differ significantly between DCM and DCMi. MK levels did not significantly correlate with NYHA class, NT-proBNP, LVEDD, or LVEF, except for a weak correlation with LVEF at follow-up. <b>Conclusions</b>: Midkine serum levels were significantly higher in patients with a DCM phenotype and severely reduced systolic function. However, these levels could not distinguish between DCM and DCMi and showed no correlation with baseline or follow-up parameters. Therefore, midkine cannot be used as a biomarker to distinguish between DCM and DCMi.https://www.mdpi.com/2227-9059/13/2/504dilated cardiomyopathymidkinebiomarkerheart failure
spellingShingle Ulrich Grabmaier
Bartolo Ferraro
Kristin Lehnert
Astrid Petersmann
Stephan B. Felix
Ludwig T. Weckbach
Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
Biomedicines
dilated cardiomyopathy
midkine
biomarker
heart failure
title Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
title_full Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
title_fullStr Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
title_full_unstemmed Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
title_short Midkine Serum Levels in Inflammatory and Non-Inflammatory Dilated Cardiomyopathy
title_sort midkine serum levels in inflammatory and non inflammatory dilated cardiomyopathy
topic dilated cardiomyopathy
midkine
biomarker
heart failure
url https://www.mdpi.com/2227-9059/13/2/504
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