Urinary Marker Profiles in Heart Failure with Reduced Versus Preserved Ejection Fraction.pdf (1.03 MB)
Urinary Marker Profiles in Heart Failure with Reduced Versus Preserved Ejection Fraction
journal contributionposted on 2023-09-22, 09:29 authored by KW Streng, HL Hillege, JM ter Maaten, DJ van Veldhuisen, K Dickstein, NJ Samani, LL Ng, M Metra, GS Filippatos, P Ponikowski, F Zannad, SD Anker, P van der Meer, CC Lang, AA Voors, K Damman
Background: Recent data suggest different causes of renal dysfunction between heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF). We therefore studied a wide range of urinary markers reflecting different nephron segments in heart failure patients. Methods: In 2070, in chronic heart failure patients, we measured several established and upcoming urinary markers reflecting different nephron segments. Results: Mean age was 70 ± 12 years, 74% was male and 81% (n = 1677) had HFrEF. Mean estimated glomerular filtration rate (eGFR) was lower in patients with HFpEF (56 ± 23 versus 63 ± 23 ml/min/1.73 m2, P = 0.001). Patients with HFpEF had significantly higher values of NGAL (58.1 [24.0–124.8] versus 28.1 [14.6–66.9] μg/gCr, P < 0.001) and KIM-1 (2.28 [1.49–4.37] versus 1.79 [0.85–3.49] μg/gCr, P = 0.001). These differences were more pronounced in patients with an eGFR > 60 ml/min/1.73m2. Conclusions: HFpEF patients showed more evidence of tubular damage and/or dysfunction compared with HFrEF patients, in particular when glomerular function was preserved.
Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation [CVON2014-11 RECONNECT] and a grant from the European Commission [FP7-242209-BIOSTAT-CHF]
Author affiliationDepartment of Cardiovascular Sciences, University of Leicester
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