PreprintArticleVersion 1This version is not peer-reviewed
Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction
Version 1
: Received: 27 August 2024 / Approved: 28 August 2024 / Online: 29 August 2024 (06:08:42 CEST)
How to cite:
Berezina, T.; Berezin, O. O.; Lichtenauer, M.; Berezin, A. E. Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction. Preprints2024, 2024082101. https://doi.org/10.20944/preprints202408.2101.v1
Berezina, T.; Berezin, O. O.; Lichtenauer, M.; Berezin, A. E. Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction. Preprints 2024, 2024082101. https://doi.org/10.20944/preprints202408.2101.v1
Berezina, T.; Berezin, O. O.; Lichtenauer, M.; Berezin, A. E. Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction. Preprints2024, 2024082101. https://doi.org/10.20944/preprints202408.2101.v1
APA Style
Berezina, T., Berezin, O. O., Lichtenauer, M., & Berezin, A. E. (2024). Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction. Preprints. https://doi.org/10.20944/preprints202408.2101.v1
Chicago/Turabian Style
Berezina, T., Michael Lichtenauer and Alexander E Berezin. 2024 "Circulating Cell-Free Nuclear DNAs Predicted an Improvement of Systolic Left Ventricular Function in Individuals with Chronic Heart Failure with Reduced Ejection Fraction" Preprints. https://doi.org/10.20944/preprints202408.2101.v1
Abstract
Patients with heart failure (HF) with improved LVEF (HFimpEF) demonstrate better clinical outcomes when compared with individuals without restoration of cardiac function. Identification of predictors for HFimpEF may play a crucial role in individual management of HF with reduced EF (HFrEF). Cell-free nuclear (cf-nDNA) DNA are released from damaged cells and contribute to adverse cardiac remodeling, cardiac dysfunction and inflammation. The purpose of the study was to elucidate whether cf-nDNAs are associated with HFimpEF. It has been prescreened 1416 patients with HF using local database. Between October 2021 and August 2022 we included 452 patients chronic HFrEF after prescription of optimal guideline-based therapy and identified HFimpEF in 177 individuals from them according to the criteria of European Society of Cardiology. Measurements of circulating biomarkers were performed at baseline and in 6 months. Detection of cf-nDNA was executed with real time quantitative PCR (qPCR) using NADH dehydrogenase, ND2 and beta-2-microglobulin. We found that HFimpEF was associated with a significant decrease in the levels of cf-nDNA when compared with the patients from persistent HFrEF cohort. Presence of ischemia-induced cardiomyopathy (odds ration [OR] = 0.75; confidence interval [CI] = 0.62 – 0.88; p = 0.044), type 2 diabetes mellitus (OR = 0.77; CI = 0.71 – 0.82; p = 0.042) and digoxin administration (OR = 0.85; CI = 0.72-0.97; p = 0.042) were negative factors for HFimpEF, whereas NT-proBNP ≤1940 pmol/mL (OR = 1.42; 95% CI = 1.19-1.98, p = 0.001), relative decrease in NT-proBNP levels (>35% vs. ≤35%) from baseline (OR = 1.52; 95% CI = 1.38-0.69, p = 0.001) and cf-nDNA ≤7.5 μmol/L (OR = 1.56; 95% CI = 1.07-2.94, p = 0.001) were positive predictors for HFimpEF. Multivariate logistic regression adjusted to ischemia-induced cardiomyopathy, IV HF NYHA class, and digoxin use yielded that NT-proBNP ≤1940 pmol/mL (OR = 1.43; 95% CI = 1.21-1.88, p = 0.001) and cf-nDNA ≤7.5 μmol/L (OR = 1.64; 95% CI = 1.19-2.15, p = 0.001) independently predicted HFimpEF. In conclusions: we established that the levels of cf-nDNA≤7.5 μmol/L independently predicted HFimpEF and improved discriminative ability of as single measured NT-proBNP as well as relative decrease in NT-proBNP levels ≤35% from baseline.
Keywords
heart failure with improved ejection fraction; heart failure with reduced ejection fraction; cell-free nuclear DNA; biomarkers
Subject
Medicine and Pharmacology, Clinical Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
