Fibroblast growth factor 21 in patients with cardiac cachexia: a possible role of chronic inflammation. (20th August 2019)

• Record Type: Journal Article
• Authors: Refsgaard Holm, Maria; Christensen, Heidi; Rasmussen, Jon; Johansen, Marie Louise; Schou, Morten; Faber, Jens; Kistorp, Caroline
• Is Part Of: ESC heart failure. Volume 6:Number 5(2019)
• Page Start: 983
• Page End: 991
• Publication Date: 2019-08-20
• Subjects: Fibroblast growth factor 21 -- FGF‐21 -- Monocyte chemoattractant protein 1 -- Cardiac cachexia -- Muscle wasting -- Heart failure with reduced ejection fraction; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.12502
• Languages: English
• ISSNs: 2055-5822

Abstract

Abstract: Aims: Cardiac cachexia is a wasting syndrome characterized by chronic inflammation and high mortality. Fibroblast growth factor 21 (FGF‐21) and monocyte chemoattractant protein 1 (MCP‐1) are associated with cardiovascular disease and systemic inflammation. We investigated FGF‐21 and MCP‐1 in relations to cardiac function, inflammation, and wasting in patients with heart failure with reduced ejection fraction (HFrEF) and cardiac cachexia. Methods and results: Plasma FGF‐21 and MCP‐1 were measured in a cross‐sectional study among the three study groups: 19 patients with HFrEF with cardiac cachexia, 19 patients with HFrEF without cachexia, and 19 patients with ischaemic heart disease and preserved ejection fraction. Patients with HFrEF and cardiac cachexia displayed higher FGF‐21 levels median (inter quantile range) 381 (232–577) pg/mL than patients with HFrEF without cachexia 224 (179–309) pg/mL and ischaemic heart disease patients 221 (156–308) pg/mL ( P = 0.0496). No difference in MCP‐1 levels were found among the groups ( P = 0.345). In a multivariable regression analysis, FGF‐21 (logarithm 2) was independently associated with interleukin 6 (logarithm 2) ( P = 0.015) and lower muscle mass ( P = 0.043), while no relation with N‐terminal pro‐hormone brain natriuretic peptide was observed. Conclusions: Fibroblast growth factor 21 (FGF‐21) levels were elevated in patients with HFrEF and cardiac cachexia, which could be mediated by increased inflammation and muscle wasting rather than impaired cardiac function.