Influences of Ivabradine treatment on serum levels of cardiac biomarkers sST2, GDF-15, suPAR and H-FABP in patients with chronic heart failure.

Abstract

Chronic heart failure (CHF) represents a major cause of hospitalization and death. Recent evidence shows that novel biomarkers such as soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR) and heart-type fatty acid binding protein (H-FABP) are correlated with inflammatory and ischemic responses in CHF patients. In this study we examined the effects of Ivabradine that inhibited the hyperpolarization-activated cyclic nucleotide-gated channel (HCN channel, also called funny current If), thereby leading to selective heart rate reduction and improved myocardial oxygen supply on the cardiac biomarkers sST2, GDF-15, suPAR and H-FABP in 50 CHF patients at the University Hospital of Jena. Patients were divided into three groups based on the etiology of CHF: dilated cardiomyopathy (DCM, n=20), ischemic cardiomyopathy (ICM, n=20) and hypertensive cardiomyopathy (HCM, n=10). The patients were administered Ivabradine (5 mg, bid for 3 months, and 7.5 mg bid for further 3 months). Analyses of cardiovascular biomarkers were performed at baseline as well as at 3- and 6-month follow-ups. At 6-month follow-up, GDF-15 levels were significantly reduced compared to baseline levels (P=0.0215), indicating a reduction in the progress of cardiac remodeling. H-FABP concentration was significantly lower in DCM patients compared to ICM (1.89 vs 3.24 μg/mL) and HCM patients (1.89 vs 3.80 μg/mL), and decreased over the 6-month follow-up (P=0.0151). suPAR median levels remained elevated, implying major ongoing inflammatory processes. As shown by significant decreases in GDF-15 and H-FABP levels, a reduction in ventricular remodeling and sub-clinical ischemia could be assumed. However, markers of hemodynamic stress (sST2) and inflammation (suPAR) showed no change or progression after 6 months of Ivabradine treatment in CHF patients. Further studies are necessary to validate the clinical applicability of these novel cardiovascular biomarkers.

• Authors: Peter Jirak, Dzeneta Fejzic, Vera Paar, Bernhard Wernly, Rudin Pistulli, Ilonka Rohm, Christian Jung, Uta C Hoppe, P Christian Schulze, Michael Lichtenauer, Atilla Yilmaz, Daniel Kretzschmar
• Journal: Acta pharmacologica Sinica (Acta Pharmacol Sin) Vol. 39 Issue 7 Pg. 1189-1196 (Jul 2018) ISSN: 1745-7254 [Electronic] United States
• PMID: 29239349 (Publication Type: Journal Article)

Chemical References

• Benzazepines
• Biomarkers
• FABP3 protein, human
• Fatty Acid Binding Protein 3
• GDF15 protein, human
• Growth Differentiation Factor 15
• Receptors, Somatostatin
• Receptors, Urokinase Plasminogen Activator
• Ivabradine
• somatostatin receptor 2

Topics

• Adult
• Aged
• Aged, 80 and over
• Benzazepines (therapeutic use)
• Biomarkers (blood)
• Chronic Disease
• Fatty Acid Binding Protein 3 (blood)
• Growth Differentiation Factor 15 (blood)
• Heart Failure (blood, drug therapy)
• Humans
• Ivabradine
• Middle Aged
• Receptors, Somatostatin (blood)
• Receptors, Urokinase Plasminogen Activator (blood)
• Young Adult