Urinary peptides in heart failure: a link to molecular pathophysiology.
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He Tianlin, Mischak Michaela, Clark Andrew L, Campbell Ross T, Delles Christian, Díez Javier, Filippatos Gerasimos, Mebazaa Alexandre, McMurray John J V, González Arantxa, Raad Julia, Stroggilos Rafael, Bosselmann Helle S, Campbell Archie, Kerr Shona M, Jackson Colette E, Cannon Jane A, Schou Morten, Girerd Nicolas, Rossignol Patrick, McConnachie Alex, Rossing Kasper, Schanstra Joost P, Zannad Faiez, Vlahou Antonia, Mullen William, Jankowski Vera, Mischak Harald, Zhang Zhenyu, Staessen Jan A, Latosinska Agnieszka
Аннотация
METHODS AND RESULTS: Analysable data from 5608 participants were available in the Human Urinary Proteome database. The urinary peptide profiles from participants diagnosed with HFrEF, HFmrEF, HFpEF and controls matched for sex, age, estimated glomerular filtration rate, systolic and diastolic blood pressure, diabetes and hypertension were compared applying the Mann-Whitney test, followed by correction for multiple testing. Unsupervised learning algorithms were applied to investigate groups of similar urinary profiles. A total of 577 urinary peptides significantly associated with HF were sequenced, 447 of which (77%) were collagen fragments. In silico analysis suggested that urinary biomarker abnormalities in HF principally reflect changes in collagen turnover and immune response, both associated with fibrosis. Unsupervised clustering separated study participants into two clusters, with 83% of non-HF controls allocated to cluster 1, while 65% of patients with HF were allocated to cluster 2 (P < 0.0001). No separation based on HF subtype was detectable.
CONCLUSIONS: Heart failure, irrespective of ejection fraction subtype, was associated with differences in abundance of urinary peptides reflecting collagen turnover and inflammation. These peptides should be studied as tools in early detection, prognostication, and prediction of therapeutic response.