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Predictive value of serum myostatin for the severity and clinical outcome of heart failure

  • Pingan Chen
    Correspondence
    Corresponding author at: Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, Guangdong 510182, China.
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Zhen Liu
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Yishan Luo
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Lushan Chen
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Shaonan Li
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Yizhi Pan
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Xiaoming Lei
    Affiliations
    Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China

    Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
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  • Daihong Wu
    Affiliations
    Ultrasonic Department, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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  • Dingli Xu
    Affiliations
    State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Key Laboratory for Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China
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      Highlights

      • The higher of serum myostatin the more serious of heart failure
      • High serum myostatin related to elevated died or rehospitalization rate.
      • Myostatin reflected the severity and prognosis of heart failure.

      Abstract

      Background

      The exact relationship between serum myostatin and the severity and prognosis of chronic heart failure (CHF) is unclear. In this study, we investigated the association between serum myostatin and the severity and prognosis in patients with CHF.

      Methods

      Two hundred and eighty-eight CHF patients and 62 healthy controls were studied. Cardiac ultrasound and serum myostatin, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were detected. CHF patients were divided into 3 groups according to tertiles of NT-proBNP or myostatin levels respectively.

      Results

      Serum myostatin levels were higher in CHF patients than in controls. New York Heart Association (NYHA) class IV patients had the highest levels of serum myostatin among the four NYHA classes. Compared with the low tertile NT-proBNP group, serum myostatin levels were significantly higher in the moderate and high tertile groups (15.47 ± 4.25 vs. 14.18 ± 3.69 ng/mL, p = .026; 16.28 ± 5.34 vs. 14.18 ± 3.69 ng/mL, p = .002). During 51-months follow-up, of 173 patients there were 36 deaths. Compared to survivors, nonsurvivors had significantly higher serum myostatin (18.11 ± 4.52 vs. 14.85 ± 5.11 ng/mL, p < .01). Patients in the high tertile myostatin group had lower survival rate (73.95% vs. 93.75%; p < .05) and larger number of CHF rehospitalization than those in the low tertile group. Cox regression analysis showed that serum myostatin was an independent predictor of mortality.

      Conclusions

      Serum myostatin levels can reflect the severity of CHF and be a predictor of adverse prognosis in CHF patients.

      Keywords

      Abbreviations:

      CHF (chronic heart failure), NYHA (New York Heart Association), NT-proBNP (N-terminal pro-B-type natriuretic peptide), LVEF (left ventricular ejection fraction), ROC (receiver operating characteristic), IHD (ischemic heart disease), AUC (area under the curve.)
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