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Abstract

Background: Acutely Decompensated Chronic Heart Failure (ADHF) is considered a life-threatening event. Despite contemporary treatment strategies of ADHF, frequent recurrent hospitalizations due to other cardiovascular reasons after discharge of patients from the hospital are occurred. The objective of the study was to examine prognostic value of circulating Endothelial-Derived Apoptotic Microparticles (EMPs) to endothelial origin Mononuclear Progenitor Cells (MPCs) ratio for post-discharged patients with clinical stabilization after ischemic ADHF. Methods: We have consecutively enrolled 136 patients (62 male) with CAD admitted with a primary diagnosis of ADHF. All the patients have given their written informed consent for participation in the study. At baseline, all enrolled patients were hemodynamically stable and they had NYHA III/IV classes of ischemic CHF. Observation period started at discharge from the hospital and was up to 3 years. Flow cytometry analysis for quantifying the number of EMPs and angiogenic MPCs was used. Results: Calculated EMPs to MPCs ratios in survived and died patient cohort were 8.4 (95% CI=7.6�9.2) and 78.9 (95% CI=53.0� 116.6), respectively (p=0.001). MPCs, EMPs, NYHA class, NT-proBNP and increased NT-proBNP >30% within 24-48 hours of admission period remained statistically significant for all-cause mortality, CHF-related death, and CHF-related rehospitalisation, whereas LVEF and hs-CRP for all variables did not. We found that the addition of EPMs to MPCs ratio to the ABC model (NT-pro- BNP, increased NT-pro-BNP>30%) improved the relative IDI by 19.6% for all-cause mortality, by 21.7% for CHF-related death, and by 19.5% for CHF-related rehospitalisation. Conclusion: We demonstrated that EMPs to MPCs ratio is considered more tremendous indicator of an imbalance between angiogenic and apoptotic responses with possible relation to cardiovascular outcomes in post-discharged patients with clinical stabilization after ischemic ADHF.

Biography

Email: dr_berezin@mail.ru