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. 2025 May 23:S1071-9164(25)00236-2.
doi: 10.1016/j.cardfail.2025.04.014. Online ahead of print.

The Association Between Serially Measured Circulating Biomarker Patterns and Pulmonary Artery Pressures Measured by Invasive Hemodynamic Monitoring

Mylène Barry-Loncq DE Jong  1 , Youssra Allach  1 , Sabrina Abou Kamar  1 , Pascal R D Clephas  1 , Hans-Peter Brunner-LA Rocca  2 , M Louis Handoko  3 , Vokko P VAN Halm  4 , Wouter E M Kok  4 , Folkert W Asselbergs  4 , Roland R J VAN Kimmenade  5 , Saskia L M A Beeres  6 , Michiel Rienstra  7 , Mariusz K Szymanski  8 , Rudolf A DE Boer  1 , Isabella Kardys  1 , Jasper J Brugts  9
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Free article

The Association Between Serially Measured Circulating Biomarker Patterns and Pulmonary Artery Pressures Measured by Invasive Hemodynamic Monitoring

Mylène Barry-Loncq DE Jong et al. J Card Fail. .
Free article

Abstract

Background: Invasive hemodynamic monitoring devices provide relevant insights into the hemodynamic status of heart failure (HF) patients. Additionally, circulating biomarkers have been advocated as additives in HF management by offering prognostic information and therapeutic targets. However, limited data exist correlating serially measured biomarkers to hemodynamic pressures provided by invasive sensors. This study aims to investigate the association between serial biomarker patterns and pulmonary artery (PA) pressure dynamics in HF patients.

Methods and results: This study is a substudy of MONITOR-HF (Remote Haemodynamic Monitoring of Pulmonary Artery Pressures in Patients With Chronic Heart Failure) (NTR7673), a prospective investigator-initiated multicenter randomized clinical trial conducted in chronic HF (CHF) patients. Blood samples were collected at baseline and 3, 6, and 12 months of follow-up, and 92 proteins (OLINK CV-III panel) were measured. The primary endpoint was the average mean PA pressure (mPAP) during the week preceding blood sample collection, in patients who received an invasive PA pressure sensor. Linear mixed models were used to evaluate the association between serial biomarker levels and mPAP, adjusting for sex and age, and correcting for multiple testing. This study included 165 patients who had a median age of 68 years (interquartile range, 61-75 years) and were predominantly male (78%). Fifteen biomarkers were significantly associated with the 7-day average mPAP, with 13 biomarkers maintaining consistent associations across different lag times. The strongest associations were found between mPAP and N-terminal pro-B-type natriuretic peptide, pulmonary surfactant protein D, insulin-like growth factor binding protein 7, and matrix metalloproteinase-2.

Conclusions: We found a consistent association between invasive hemodynamic pressures and 13 serially measured blood biomarkers in chronic HF patients. These results could deepen the understanding and therapy guidance of congestive HF.

Keywords: Biomarkers; congestion; heart failure; pulmonary artery pressures; repeated measurements.

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Conflict of interest statement

Declaration of competing interest H.P.B.L.R. reports unrestricted research grants from Vifor, and Roche Diagnostics, and reports consultancy fees and payments for lectures from Vifor Pharma, Novartis, Boehringer Ingelheim, and Roche Diagnostics. M.L.H. is supported by study the Dutch Heart Foundation (2020 T058) and the Netherlands CardioVascular Research Initiative (2020B008) and received unrestricted research grants from Vifor; he also received an educational grant from Novartis and Boehringer Ingelheim, and speaker/consultancy fees from Novartis, Boehringer Ingelheim, Daiichi Sankyo, Vifor Pharma, AstraZeneca, Bayer, MSD, Abbott, and Quin Medical; all not related to this work. W.E.M.K. received speaker fees from Novartis. R.v.K. has received grants from the Dutch Heart Foundation and the Netherlands Heart Institute; received consulting fees from Novartis Pharma and Bayer; received support for attending meetings and/or travel from Roche Diagnostics; and has a leadership or fiduciary role in other board society in Nuceus ESC WG PAAD. S.L.M.A.B. received speaker/consulting fees from Boston Scientific Medtronic Trading and Boehringer Ingelheim. M.R. reports grants from ZonMW and the Dutch Heart Foundation; unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation; unrestricted research grant from the European Union's Horizon 2020 research and innovation program, and consultancy fees to the institution from Bayer and InCarda Therapeutics, outside the submitted work. M.K.S. reports speaker fee from AstraZeneca, outside the submitted work. R.A.d.B. has received research grants or fees from AstraZeneca, Abbott, Boehringer Ingelheim, Cardior Pharmaceuticals, Novo Nordisk, and Roche; and has had speaker engagements with Abbott, AstraZeneca, Bayer, Bristol Myers Squibb, Cardior Pharmaceuticals GmBh, Novo Nordisk and Roche. I.K. reports travel reimbursement from Olink Proteomics and SomaLogic, outside the submitted work. J.J.B. received an independent research grant from Abbott for investigator-initiated studies to the hospital and reports speaker engagement or advisory board engagements (5 years) from AstraZeneca, Abbott, Boehringer Ingelheim, Bayer, Daiichi Sankyo, Novartis, and Vifor. All other authors have nothing to disclose.

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