The relationship between serum uric acid level and concentration of proangiogenic mononuclear progenitor cells in patients with chronic heart failure

Year 2014, Volume: 5 Issue: 4, 511 - 520, 01.12.2014

Alexander E Berezin Alexander A Kremzer

https://doi.org/10.5799/ahinjs.01.2014.04.0449

Abstract

Objective: Serum uric acid (UA) is considered as a marker of natural progression of chronic heart failure (CHF). Progression of CHF associates with declining of circulating mononuclear progenitor cells (MPCs) in the blood. The objective of this study was to evaluate the interrelationship between SUA concentrations and proangiogenic MPCs in ischemic CHF patients. Methods: The study was structured retrospectively after determining the coronary artery disease (CAD) by contrast-enhanced spiral computed tomography angiography in 126 subjects (54 male), aged 48 to 62 years, with CHF. Serum UA level was measured by enzymatic method and N-terminal proBNP (NT-pro-BNP) level was examined by immunoelectrochemiluminesence method. All biomarkers were measured at baseline. Results: Concentrations of SUA were distributed by quartiles (Me; IQR): QI=20.11 (19.06; 22.33) mmol/l; QII=27.53 (23.2; 31.10) mmol/l; QIII=35.80 (32.0; 39.0) mmol/l; and QIV=44.9 (40.00; 49.60) mmol/l. Cox proportional adjusted Odds Ratios analyses for CD14+CD309+ and CD14+CD309+Tie2+ MPCs by SUA Quartiles (Q) has showed that high Q (Q3 and Q4) of SUA versus low Q (Q1 and Q2) associated with increased risk of depletion of both CD14+CD309+ and CD14+CD309+Tie2+ MPCs. The ROC analysis has been showed that there was the cut-off point for the SUA level with the best prognostic potential on the risk of decreasing MPCs in both models equal 31.5 mmol/l. Conclusion: Circulated level of proangiogenic MPCs is declined progressively depended on quartiles of serum UA level in CHF subjects. We suggest that mild elevation of serum UA might be considered as a predictor of low proangiogenic MPCs in CHF patients. J Clin Exp Invest 2014; 5 (4): 511-520

Keywords

Chronic heart failure, serum uric acid, circulating mononuclear progenitor cells, predictive value

Kronik kalp yetmezliği bulunan hastalarda serum ürik asit düzeyi ile proanjiojenik mononükleer projenitör hücre konsantrasyonu arasındaki ilişki

Abstract

Amaç: Serum ürik asit (ÜA) kronik kap yetmezliğinin (KKY) doğal ilerleyişinin bir belirteci olarak bilinir. KKY ilerlemesi kanda dolaşan mononükleer projenitör hücrelerin (MPH) azalması ile birliktedir. Bu çalışmanın amacı iskemik KKY\'li hasatlarda serum ÜA ve proanjiyojenik MPH konsantrasyonları arasındaki ilişkiyi değerlendirmektir. Yöntemler: Bu çalışma kontrastlı bilgisayarlı tomografi anjiyografisi ile koroner arter hastalığı (KAH) tanısı alan KKY\'li 126 hastada (54 erkek)retrospektif olarak yapılmıştır. Serum ÜA enzimatik yöntemle ve N-terminal proBNP (NT-pro-BNP) düzeyi immünoelektrokemilüminesens yöntemi ile çalışıldı. Bulgular: Serum ÜA konsantrasyonları kuartallar olarak değerlendirildi (Me; IQR): QI=20.11 (19.06; 22.33) mmol/l; QII=27.53 (23.2; 31.10) mmol/l; QIII=35.80 (32.0; 39.0) mmol/l ve QIV=44.9 (40.00; 49.60) mmol/l. Serum ÜA\'e göre düzeltilmiş Cox oransal Odds oranı analizleri CD14+CD309+ ve CD14+CD309+Tie2+ MPH için SUA Quartiles (Q) ile yapıldı ve Yüksek serum ÜA Q (Q3 ve Q4) ve düşük Q (Q1 ve Q2)\'nin artmış CD14+CD309+ ve CD14+CD309+Tie2+ MPH tükenme riski ile birlikte olduğu gösterildi. ROC analizi ile serum ÜA 31,5 mmol/l değeri MPH azalma riski için en iyi potansiyel cut-off değeri olarak belirlendi. Sonuç: Konjestif kalp yetmezliği bulunan hastalarda dolaşan proanjiyojenik MPH, serum ÜA kuartallarına bağlı olarak ilerleyici bir şekilde azaldı. Serum ÜA\'de hafif artışın düşük proanjiyojenik MPH\'nin bir öngördürücüsü olarak kabul edilebilir.

Keywords

Kronik kalp yetmezliği, serum ürik asit, dolaşan mononükleer projenitör hücreler, prediktif değer

References

• Hartupee J, Mann DL. Positioning of inflammatory bio- markers in the heart failure landscape. J Cardiovasc Transl Res 2013;6:485-492.
• Gustafsson D, Unwin R. The pathophysiology of hyper- uricaemia and its possible relationship to cardiovas- cular disease, morbidity and mortality. BMC Nephrol 2013;14:164.
• Huang H, Huang B, Li Y, et al. Uric acid and risk of heart failure: a systematic review and meta-analysis. Eur J Heart Fail. 2013 Aug 9. [Epub ahead of print]
• Jeemon P, Prabhakaran D. Does uric acid qualify as an independent risk factor for cardiovascular mortality? Clin Sci (Lond) 2013;124:255-257.
• Kuo CF, See LC, Yu KH, et al. Significance of serum uric acid levels on the risk of all-cause and cardiovas- cular mortality. Rheumatology (Oxford) 2013;52:127- 134.
• Rehman J, Li J, Orschell CM, March KL. Peripheral blood “endothelial progenitor cells” are derived from monocyte/macrophages and secrete angiogenic growth factors. Circulation 2003;107:1164-1169.
• Schmidt-Lucke C, Roёssig L, Fichtlscherer S, et al. Reduced number of circulating endothelial progeni- tor cells predicts future cardiovascular events: proof of concept for the clinical importance of endogenous vascular repair. Circulation 2005;111:2981-2987.
• Hill JM, Zalos G, Halcox JP, et al. Circulating endothe- lial progenitor cells, vascular function, and cardiovas- cular risk. N Engl J Med 2003;348: 593-600.
• Valgimigli M, Rigolin GM, Fucili A, et al. CD34+ and endothelial progenitor cells in patients with vari- ous degrees of congestive heart failure. Circulation 2004;110:1209-1212.
• Kissel CK, Lehmann R, Assmus B, et al. Selective functional exhaustion of hematopoietic progenitor cells in the bone marrow of patients with postinfarction heart failure. J Am Coll Cardiol 2007;49:2341-2349
• Fadini GP, Maruyama S, Ozaki T, et al. Circulating pro- genitor cell count for cardiovascular risk stratification: a pooled analysis. PLoS ONE 2010; 5, e11488.
• Fritzenwanger M, Lorenz F, Jung C, et al. Differential number of cd34+, cd133+ and cd34+/cd133+ cells in peripheral blood of patients with congestive heart fail- ure. Eur J Med Res 2009;14:113-117.
• Bakogiannis C, Tousoulis D, Androulakis E, et al. Cir- culating endothelial progenitor cells as biomarkers for prediction of cardiovascular outcomes. Curr Med Chem 2012;19:2597-2604.
• McMurray JJV, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012;33:1787-1847
• Schiller NB., Shah PM., Crawford M, et al. Recom- mendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Sub- committee on Quantitation of Two-Dimensional Echo- cardiograms. J Am Soc Echocardiogr 1989;2:358- 367.
• Pellerin D., Sharma R., Elliott P., Veyrat C. Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventricular function. Heart 2003;89(90003):iii9-17
• Levey AS, Stevens LA, Schmid CH, et al. for the CKD- EPI (Chronic Kidney Disease Epidemiology Collabo- ration). A new equation to estimate glomerular filtra- tion rate. Ann Intern Med 2009;150:604-612.
• Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein choles- terol in plasma, without use of the preparative ultra- centrifuge. Clin Chem 1972;18:499-502.
• Tung JW, Parks DR, Moore WA, et al. New approach- es to fluorescence compensation and visualization of FACS data. Clin Immunol 2004;110:277-283.
• Málek F, Ošťádal P, Pařenica J, et al. Uric acid, allopu- rinol therapy, and mortality in patients with acute heart failure-results of the Acute HEart FAilure Database registry. J Crit Care 2012;27:737.e11-24.
• Manzano L, Babalis D, Roughton M, et al; SE- NIORS Investigators. Predictors of clinical outcomes in elderly patients with heart failure. Eur J Heart Fail 2011;13:528-536.
• Tamariz L, Harzand A, Palacio A, et al. Uric acid as a predictor of all-cause mortality in heart failure: a meta- analysis. Congest Heart Fail 2011;17:25-30.
• Alcaíno H, Greig D, Castro P, et al. The role of uric acid in heart failure. Rev Med Chil 2011;139:505-515.
• Hsieh MC, Su HM, Wang SY, et al. Significant cor- relation between left ventricular systolic and diastolic dysfunction and decreased glomerular filtration rate. Ren Fail 2011;33:977-982.
• Amin A, Vakilian F, Maleki M. Serum uric acid levels correlate with filling pressures in systolic heart failure. Congest Heart Fail 2011;17:80-84.
• Misra D, Zhu Y, Zhang Y, Choi HK. The independent impact of congestive heart failure status and diuretic use on serum uric acid among men with a high cardio- vascular risk profile: a prospective longitudinal study. Semin Arthritis Rheum 2011;41:471-476.
• Filippatos GS, Ahmed MI, Gladden JD, et al. Hyper- uricaemia, chronic kidney disease, and outcomes in heart failure: potential mechanistic insights from epi- demiological data. Eur Heart J 2011;32:712-720.
• Wu AH, Ghali JK, Neuberg GW et al. Uric acid level and allopurinol use as risk markers of mortal- ity and morbidity in systolic heart failure. Am Heart J 2010;160:928-933.
• Kim H, Shin HW, Son J, et al. Uric Acid as prognostic marker in advanced nonischemic dilated cardiomyop- athy: comparison with N-terminal pro B-type natriuret- ic peptide level. Congest Heart Fail 2010;16:153-158.
• Waring WS, Webb DJ, Maxwell SRJ. Effect of lo- cal hyperuricemia on endothelial function in the hu- man forearm vascular bed. Br J Clin Pharmacol 2000;49:511-515.
• Trachtenberg BH, Hare JM. Biomarkers of oxidative stress in heart failure. Heart Fail Clin 2009;5:561-577.