Cargando…
Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease?
BACKGROUND: Homoarginine (hArg) has been shown to be of prognostic value in patients with chronic left heart failure. The present study aims to assess the clinical utility and prognostic value of hArg levels in patients with complex congenital heart disease (CHD). METHODS: Plasma hArg levels were me...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590899/ https://www.ncbi.nlm.nih.gov/pubmed/28886170 http://dx.doi.org/10.1371/journal.pone.0184333 |
_version_ | 1783262608591159296 |
---|---|
author | Raedle-Hurst, Tanja Mueller, Marieke Meinitzer, Andreas Maerz, Winfried Dschietzig, Thomas |
author_facet | Raedle-Hurst, Tanja Mueller, Marieke Meinitzer, Andreas Maerz, Winfried Dschietzig, Thomas |
author_sort | Raedle-Hurst, Tanja |
collection | PubMed |
description | BACKGROUND: Homoarginine (hArg) has been shown to be of prognostic value in patients with chronic left heart failure. The present study aims to assess the clinical utility and prognostic value of hArg levels in patients with complex congenital heart disease (CHD). METHODS: Plasma hArg levels were measured in 143 patients with complex CHD and compared to clinical status, echocardiographic and laboratory parameters as well as the occurrence of adverse cardiac events. RESULTS: Median hArg levels were 1.5 μmol/l in CHD patients as compared to 1.70 μmol/l in healthy controls (p = 0.051). Median hArg levels were lowest in patients with Fontan palliation (1.27 μmol/l) and Eisenmenger physiology (0.99 μmol/l) and decreased with the severity of adverse cardiac events with lowest values found in patients prior to death or overt heart failure (0.89 μmol/l). According to ROC analysis, the most important predictors of adverse cardiac events were hArg levels (AUC 0.837, p<0.001, CI 0.726–0.947), NYHA class (AUC 0.800, p<0.001, CI 0.672–0.928) and NT-proBNP levels (AUC 0.780, p<0.001, CI 0.669–0.891). The occurrence of overt heart failure or death due to progressive heart failure were best predicted by NYHA class (AUC 0.945, p<0.001, CI 0.898–0.992), hArg levels (AUC 0.911, p<0.001, CI 0.850–0.971) and NT-proBNP levels (AUC 0.877, p<0.001, CI 0.791–0.962), respectively. CONCLUSION: In patients with complex CHD, hArg levels can predict adverse cardiac events as reliably as or even better than NT-proBNP levels and thus might be of prognostic value in this subset of patients. |
format | Online Article Text |
id | pubmed-5590899 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-55908992017-09-15 Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? Raedle-Hurst, Tanja Mueller, Marieke Meinitzer, Andreas Maerz, Winfried Dschietzig, Thomas PLoS One Research Article BACKGROUND: Homoarginine (hArg) has been shown to be of prognostic value in patients with chronic left heart failure. The present study aims to assess the clinical utility and prognostic value of hArg levels in patients with complex congenital heart disease (CHD). METHODS: Plasma hArg levels were measured in 143 patients with complex CHD and compared to clinical status, echocardiographic and laboratory parameters as well as the occurrence of adverse cardiac events. RESULTS: Median hArg levels were 1.5 μmol/l in CHD patients as compared to 1.70 μmol/l in healthy controls (p = 0.051). Median hArg levels were lowest in patients with Fontan palliation (1.27 μmol/l) and Eisenmenger physiology (0.99 μmol/l) and decreased with the severity of adverse cardiac events with lowest values found in patients prior to death or overt heart failure (0.89 μmol/l). According to ROC analysis, the most important predictors of adverse cardiac events were hArg levels (AUC 0.837, p<0.001, CI 0.726–0.947), NYHA class (AUC 0.800, p<0.001, CI 0.672–0.928) and NT-proBNP levels (AUC 0.780, p<0.001, CI 0.669–0.891). The occurrence of overt heart failure or death due to progressive heart failure were best predicted by NYHA class (AUC 0.945, p<0.001, CI 0.898–0.992), hArg levels (AUC 0.911, p<0.001, CI 0.850–0.971) and NT-proBNP levels (AUC 0.877, p<0.001, CI 0.791–0.962), respectively. CONCLUSION: In patients with complex CHD, hArg levels can predict adverse cardiac events as reliably as or even better than NT-proBNP levels and thus might be of prognostic value in this subset of patients. Public Library of Science 2017-09-08 /pmc/articles/PMC5590899/ /pubmed/28886170 http://dx.doi.org/10.1371/journal.pone.0184333 Text en © 2017 Raedle-Hurst et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Raedle-Hurst, Tanja Mueller, Marieke Meinitzer, Andreas Maerz, Winfried Dschietzig, Thomas Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title | Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title_full | Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title_fullStr | Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title_full_unstemmed | Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title_short | Homoarginine—A prognostic indicator in adolescents and adults with complex congenital heart disease? |
title_sort | homoarginine—a prognostic indicator in adolescents and adults with complex congenital heart disease? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590899/ https://www.ncbi.nlm.nih.gov/pubmed/28886170 http://dx.doi.org/10.1371/journal.pone.0184333 |
work_keys_str_mv | AT raedlehursttanja homoarginineaprognosticindicatorinadolescentsandadultswithcomplexcongenitalheartdisease AT muellermarieke homoarginineaprognosticindicatorinadolescentsandadultswithcomplexcongenitalheartdisease AT meinitzerandreas homoarginineaprognosticindicatorinadolescentsandadultswithcomplexcongenitalheartdisease AT maerzwinfried homoarginineaprognosticindicatorinadolescentsandadultswithcomplexcongenitalheartdisease AT dschietzigthomas homoarginineaprognosticindicatorinadolescentsandadultswithcomplexcongenitalheartdisease |