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. 2024 Sep 9;14(9):1137.
doi: 10.3390/biom14091137.

Prognostic Value of Circulating Fibrosis Biomarkers in Dilated Cardiomyopathy (DCM): Insights into Clinical Outcomes

Elham Kayvanpour  1   2 , Farbod Sedaghat-Hamedani  1   2 , Daniel Tian Li  1   2 , Tobias Miersch  1 , Tanja Weis  1   2 , Imo Hoefer  3 , Norbert Frey  1   2 , Benjamin Meder  1   2   4
Affiliations

Prognostic Value of Circulating Fibrosis Biomarkers in Dilated Cardiomyopathy (DCM): Insights into Clinical Outcomes

Elham Kayvanpour et al. Biomolecules. .

Abstract

Background: Dilated cardiomyopathy (DCM) involves myocardial remodeling, characterized by significant fibrosis and extracellular matrix expansion. These changes impair heart function, increasing the risk of heart failure and sudden cardiac death. This study investigates the prognostic value of circulating fibrosis biomarkers as a less invasive method in DCM patients.

Methods: Plasma samples from 185 patients with confirmed DCM were analyzed to measure 13 circulating biomarkers using Luminex bead-based multiplex assays and ELISA. The prognostic value of these biomarkers was evaluated concerning heart failure-associated events and all-cause mortality.

Results: Elevated MMP-2 levels (>1519.3 ng/mL) were linked to older age, higher diabetes prevalence, lower HDL, increased NT-proBNP and hs-TnT levels, and severe systolic dysfunction. High TIMP-1 levels (>124.9 ng/mL) correlated with elevated NT-proBNP, more atrial fibrillation, reduced exercise capacity, and larger right ventricles. Increased GDF-15 levels (>1213.9 ng/mL) were associated with older age, systemic inflammation, renal impairment, and poor exercise performance. Elevated OPN levels (>81.7 ng/mL) were linked to higher serum creatinine and NT-proBNP levels. Over a median follow-up of 32.4 months, higher levels of these biomarkers predicted worse outcomes, including increased risks of heart failure-related events and mortality.

Conclusions: Circulating fibrosis biomarkers, particularly MMP-2, TIMP-1, GDF-15, and OPN, are valuable prognostic tools in DCM. They reflect the severity of myocardial remodeling and systemic disease burden, aiding in risk stratification and therapeutic intervention. Integrating these biomarkers into clinical practice could improve DCM management and patient prognosis.

Keywords: GDF-15; MMP-2; OPN; TIMP-1; biomarkers; cardiac fibrosis; dilated cardiomyopathy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Circulating fibrosis biomarkers and their prognostic role in DCM: Receiver-operating characteristic (ROC) curves and corresponding area under the curve (AUC) statistics regarding composite endpoint.
Figure 1
Figure 1
Circulating fibrosis biomarkers and their prognostic role in DCM: Receiver-operating characteristic (ROC) curves and corresponding area under the curve (AUC) statistics regarding composite endpoint.
Figure 2
Figure 2
(A,B) Kaplan Meier survival estimates of the time to events depending on circulating levels of MMP-2 and TIMP-1. Patients with higher levels of these biomarkers show a significantly poorer survival rate in both endpoints.
Figure 3
Figure 3
(A,B) Kaplan Meier survival estimates of the time to events depending on circulating levels of GDF-15 and OPN. Patients with higher levels of these biomarkers show a significantly poorer survival rate in both endpoints.
See this image and copyright information in PMC

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