Abstract | BACKGROUND: METHODS AND RESULTS: In 115 patients with chronic systolic HF (left ventricular ejection fraction ≤35%), we measured plasma PBHCit by quantitative mass spectrometry and performed comprehensive echocardiography with assessment of cardiac structure and performance. Adverse long-term events ( death, cardiac transplantation) were tracked for 5 years. In our study cohort, the median PBHCit level was 87 (interquartile range 59-128) μmol/mol lysine. Higher plasma PBHcit levels were associated with poorer renal function (estimated glomerular filtration rate [eGFR]: Spearman r = -0.37; P < .001), cystatin C (r = 0.31; P = .001), and elevated plasma amino-terminal pro- B-type natriuretic peptide ( NT-proBNP) levels (r = 0.26; P = .006), but not with markers of systemic inflammation or oxidant stress ( high-sensitivity C-reactive protein and myeloperoxidase [MPO]: P > .10 for each). Furthermore, elevated plasma PBHCit levels were not related to indices of cardiac structure or function (P > .10 for all examined) except modestly with increased right atrial volume index (r = 0.31; P = .002). PBHCit levels predicted adverse long-term events (hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.3-2.6; P < .001), including after adjustment for age, eGFR, MPO, and NT-proBNP (HR 1.9, 95% CI 1.2-3.1; P = .006). CONCLUSIONS: In chronic systolic HF, protein carbamylation is associated with poorer renal but not cardiac function, and portends poorer long-term adverse clinical outcomes even when adjusted for cardiorenal indices of adverse prognosis.
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Authors | W H Wilson Tang, Kevin Shrestha, Zeneng Wang, Allen G Borowski, Richard W Troughton, Allan L Klein, Stanley L Hazen |
Journal | Journal of cardiac failure
(J Card Fail)
Vol. 19
Issue 4
Pg. 219-24
(Apr 2013)
ISSN: 1532-8414 [Electronic] United States |
PMID | 23582087
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Blood Proteins
- homocitrulline
- Citrulline
|
Topics |
- Adult
- Aged
- Blood Proteins
(metabolism)
- Chronic Disease
- Citrulline
(analogs & derivatives, blood)
- Cohort Studies
- Female
- Heart Failure, Systolic
(blood, diagnosis, therapy)
- Humans
- Kidney Diseases
(blood, diagnosis, therapy)
- Male
- Middle Aged
- Prospective Studies
- Protein Binding
(physiology)
- Time Factors
- Treatment Outcome
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