Leukocyte Extracellular Vesicles Predict Progression of Systolic Dysfunction in Heart Failure with Mildly Reduced Ejection Fraction (LYCHEE) – A Prospective, Multicentre Cohort Study

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2024年9月24日

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Aleksandra Gąsecka,
Aleksander Siniarski,
Piotr Duchnowski,
Konrad Stępień,
Ewelina Błażejowska,
Magdalena Gajewska,
Kacper Karaban,
Kinga Porębska,
Aleksandra Reda,
Sylwester Rogula,
Bartosz Rolek,
Dorota Słupik,
Roksana Gozdowska,
Marcin Kleibert,
Dominika Zajkowska,
Michał Grąt,
Marcin Grabowski,
Krzysztof J. Filipiak,
Edwin van der Pol,
Rienk Nieuwland

摘要

Risk stratification in heart failure with mildly-reduced ejection fraction (HFmrEF) remains challenging. We evaluated the predictive value of advanced glycation end products (AGEs) and plasma concentrations of extracellular vesicles (EVs) for the systolic and diastolic dysfunction progression in HFmrEF patients. Skin AGE accumulation was measured using AGE Reader. Plasma EV concentrations were measured using flow cytometry. Among 74 patients enrolled, 13 (18%) had systolic dysfunction progression and 5 (7%) had diastolic dysfunction progression during 6.5 months follow-up. Leukocyte EVs concentrations were higher in patients with systolic dysfunction progression (p = 0.002) and predicted the progression with 75.0% sensitivity and 58.3% specificity, independent of other clinical variables (OR 4.72, 95% CI 0.99–22.31). Skin AGE levels and concentrations of other EV subtypes were not associated with systolic or diastolic dysfunction progression. Increased leukocyte EVs concentrations are associated with 4.7-fold higher odds of systolic dysfunction progression in HFmrEF patients.

Graphical Abstract

AGE – advanced glycation end products, HFmrEF – heart failure with mildly reduced ejection fraction, ECHO – echocardiography, EV – extracellular vesicles