Journal
HEART AND VESSELS
Volume 31, Issue 1, Pages 52-59Publisher
SPRINGER
DOI: 10.1007/s00380-014-0571-y
Keywords
Thrombospondin-2; HFpEF; Prognosis; Biomarker
Funding
- Japan Health Foundation
- Mitsui Life Social Welfare Foundation
- Ministry of Education, Science, and Culture, Japan [B-25293186]
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Thrombospondin-2 (TSP-2) is highly expressed in hypertensive heart. Interstitial fibrosis is frequently observed in hypertensive heart, and it is a characteristic feature of heart failure with preserved ejection fraction (HFpEF). We tested here the hypothesis that high TSP-2 serum levels reflect disease severity and can predict poor prognosis of patients with HFpEF. Serum TSP-2 levels were measured by ELISA in 150 patients with HFpEF. HFpEF was defined as left ventricular ejection fraction a parts per thousand yen50 %, B-type natriuretic peptide (BNP) a parts per thousand yen100 pg/ml or E/e' a parts per thousand yen15. The endpoints were mortality rate, HF-related hospitalization, stroke and non-fatal myocardial infarction. The median serum TSP-2 level was 19.2 (14.4-26.0) ng/ml. Serum TSP-2 levels were associated with the New York Heart Association (NYHA) functional class. Circulating levels of BNP and high-sensitivity troponin T were positively correlated with serum TSP-2 levels. Kaplan-Meier survival curve showed high risk of adverse cardiovascular events in the high TSP-2 group (> median value), and that the combination of high TSP-2 and high BNP (a parts per thousand yen100 pg/ml) was associated with the worst event-free survival rate. Multivariate Cox proportional hazard analysis identified TSP-2 as independent predictor of risk of death and cardiovascular events. Circulating TSP-2 correlates with disease severity in patients with HFpEF. TSP-2 is a potentially useful predictor of future adverse cardiovascular events in patients with HFpEF.
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