Plasma Tenascin-C: a prognostic biomarker in heart failure with preserved ejection fraction. (2nd October 2020)

• Record Type: Journal Article
• Authors: Kanagala, Prathap; Arnold, Jayanth R.; Khan, Jamal N.; Singh, Anvesha; Gulsin, Gaurav S.; Chan, Daniel C. S.; Cheng, Adrian S. H.; Yang, Jing; Li, Zhuyin; Gupta, Pankaj; Squire, Iain B.; McCann, Gerry P.; Ng, Leong L.
• Is Part Of: Biomarkers. Volume 25:Number 7(2020)
• Page Start: 556
• Page End: 565
• Publication Date: 2020-10-02
• Subjects: Tenascin-C -- interstitial fibrosis -- biomarkers -- heart failure with preserved ejection fraction -- inflammation -- prognosis; Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2020.1810319
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Introduction: Tenascin-C is a marker of interstitial fibrosis. We assessed whether plasma Tenascin-C differed between heart failure with preserved ejection fraction (HFpEF) and asymptomatic controls and related to clinical outcomes. Materials and Methods: Prospective, observational study of 172 age- and sex-matched subjects (HFpEF n = 130; controls n = 42, age 73 ± 9, males 50%) who underwent phenotyping with 20 plasma biomarkers, echocardiography, cardiac MRI and 6-minute-walk-testing. The primary endpoint was the composite of all-cause death/HF hospitalisation. Results: Tenascin-C was higher in HFpEF compared to controls (13.7 [10.8–17.3] vs (11.1 [8.9–12.9] ng/ml, p < 0.0001). Tenascin-C correlated positively with markers of clinical severity (NYHA, E/E', BNP) and plasma biomarkers reflecting interstitial fibrosis (ST-2, Galectin-3, GDF-15, TIMP-1, TIMP-4, MMP-2, MMP-3, MMP-7, MMP-8), cardiomyocyte stress (BNP, NTpro-ANP), inflammation (MPO, hs-CRP, TNFR-1, IL6) and renal dysfunction (urea, cystatin-C, NGAL); p < 0.05 for all. During follow-up (median 1428 days), there were 61 composite events (21 deaths, 40 HF hospitalizations). In multivariable Cox regression analysis, Tenascin-C (adjusted hazard ratio [HR] 1.755, 95% confidence interval [CI] 1.305–2.360; p < 0.0001) and indexed extracellular volume (HR 1.465, CI 1.019–2.106; p = 0.039) were independently associated with adverse outcomes. Conclusions: In HFpEF, plasma Tenascin-C is higher compared to age- and sex-matched controls and a strong predictor of adverse outcomes. Trial registration : ClinicalTrials.gov: NCT03050593