Background: Cardiac resynchronization therapy (CRT) promotes left ventricular (LV) reverse remodelling and affects myocardial collagen turnover in heart failure (HF) patients. Osteopontin (OPN) is a matrix glycoprotein required for the activation of fibroblasts upon TGF-Î²1 stimulation. In humans, plasma OPN and OPN-expressing lymphocytes correlate with the severity of HF. We sought to evaluate whether plasma OPN and TGF-Î²1 reflect LV reverse remodelling following CRT. Methods: Eighteen patients (12 men, mean age 65 Â± 11 years) undergoing CRT were studied. Patients underwent baseline clinical and echocardiographic evaluation, and assessment of plasma OPN and TGF-Î²1. The evaluation was repeated 8.5 Â± 4 months after device implantation. Eight healthy age- and sex-matched subjects served as controls. Results: In HF patients, baseline plasma OPN and TGF-Î²1 were higher as compared to control subjects (OPN: 99 Â± 48 vs 59 Â± 22 ng/ml; p < 0.05; TGF-Î²1: 15.9 Â± 8.0 vs 9.3 Â± 5.6 ng/ml; p < 0.05). At follow-up, 12 patients responded to CRT and showed LV reverse remodelling, whereas 6 did not. Plasma OPN decreased in CRT responders (108 Â± 47 vs 84 Â± 37 ng/ml; p = 0.03) and increased in non-responders (79 Â± 58 vs 115 Â± 63 ng/ml; p < 0.01). TGF-Î²1 showed a trend towards reduction in responders (17.5 Â± 8.7 vs 10.2 Â± 8.9 ng/ml; p = 0.08) and was unchanged in non-responders. A significant correlation (r = - 0.56; p = 0.01) was found between relative changes of LVESV and plasma OPN. Conclusions: CRT-induced LV reverse remodelling is reflected by changes in plasma OPN. Circulating OPN may represent a marker of LV dilation/impairment and an indicator of the response to HF therapies promoting LV reverse remodelling. Â© 2010 Elsevier Ireland Ltd. All rights reserved.
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|Titolo:||Plasma osteopontin reveals left ventricular reverse remodelling following cardiac resynchronization therapy in heart failure|
|Data di pubblicazione:||2011|
|Appare nelle tipologie:||03.1 Articolo su rivista|