Associations of Angiopoietins With Heart Failure Incidence and Severity

JOURNAL OF CARDIAC FAILURE

卷:27

Article

Peplinski, Brandon S.¹  Houston, Brian A.²  Bluemke, David A.³  Kawut, Steven M.^4,5  Kolb, Todd M.⁶  Kronmal, Richard A.⁷  Lima, Joao A. C.^6,8  Ralph, David D.¹  Rayner, Samuel G.¹  Steinberg, Zachary L.¹  Tedford, Ryan J.²  Leary, Peter J.^1,9 

[1] Univ Washington, Dept Med, Seattle, WA USA

[2] Med Univ South Carolina, Dept Med, Charleston, SC USA

[3] Univ Wisconsin, Dept Radiol, Madison, WI USA

[4] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA USA

[5] Univ Penn, Perelman Sch Med, Dept Epidemiol, Philadelphia, PA USA

[6] Johns Hopkins Univ Hosp, Dept Med, Baltimore, MD USA

[7] Univ Washington, Dept Biostat, Seattle, WA USA

[8] Johns Hopkins Univ Hosp, Dept Radiol, Baltimore, MD USA

[9] Univ Washington, Dept Epidemiol, Seattle, WA USA

关键词: Angiopoietin;    heart failure;    clinical outcomes;   

DOI  :  10.1016/j.cardfail.2021.04.001

来源: Elsevier

【 摘 要 】

Background: Angiopoietin-1 and 2 (Ang1, Ang2) are important mediators of angiogenesis. Angiopoietin levels are perturbed in cardiovascular disease, but it is unclear whether angiopoietin signaling is causative, an adaptive response, or merely epiphenomenon of disease activity. Methods and Results: In a cohort free of cardiovascular disease at baseline (Multi-Ethnic Study of Atherosclerosis [MESA]), relationships between angiopoietins, cardiac morphology, and subsequent incidence of heart failure or cardiovascular death were evaluated. In cohorts with pulmonary arterial hypertension or left heart disease, associations between angiopoietins, invasive hemodynamics, and adverse clinical outcomes were evaluated. In MESA, Ang2 was associated with a higher incidence of heart failure or cardiovascular death (hazard ratio 1.21 per standard deviation, P<.001). Ang2 was associated with increased right atrial pressure (pulmonary arterial hypertension cohort) and increased wedge pressure and right atrial pressure (left heart disease cohort). Elevated Ang2 was associated with mortality in the pulmonary arterial hypertension cohort. Conclusions: Ang2 was associated with incident heart failure or death among adults without cardiovascular disease at baseline and with disease severity in individuals with existing heart failure. Our finding that Ang2 is increased before disease onset and that elevations reflect disease severity, suggests Ang2 may contribute to heart failure pathogenesis.

【 授权许可】

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