The relationship between systolic function and serum NGAL levels in patients with chronic heart failure of ischemic origin

Authors

  • V. A. Lysenko Zaporizhzhia State Medical University, Ukraine, Ukraine
  • V. V. Syvolap Zaporizhzhia State Medical University, Ukraine, Ukraine
  • M. S. Potapenko Zaporizhzhia State Medical University, Ukraine, Ukraine

DOI:

https://doi.org/10.14739/2310-1210.2021.2.223741

Keywords:

serum NGAL, left ventricular systolic function, chronic heart failure of ischemic origin, renal dysfunction, biomarker of tubulo-interstitial injury

Abstract

Neutrophil gelatinase-associated lipocalin (NGAL) is considered one of the most informative biomarkers of chronic kidney disease (CKD). NGAL can also serve as a biomarker of cardiovascular disease and heart failure (HF). However, the relationship between systolic function and serum NGAL concentrations in patients with chronic HF (CHF) of ischemic origin remains insufficiently studied.

The aim. To study the influence of tubulo-interstitial injury marker NGAL on systolic function in patients with CHF of ischemic origin.

Materials and methods. The study included 51 patients with CHF, stage II AB, NYHA II-IV FC. Doppler echocardiographic examination was performed on the device Esaote MyLab Eight (Italy) according to standard methods. NGAL levels were analyzed using an ELISA kit (E-EL-H0096, Elabscience, USA). Depending to the concentration of serum NGAL, the patients were divided into 2 subgroups. In the first group (n = 37), the NGAL level was higher than 168 ng/ml, in the second (n = 14) – less than 168 ng/ml.

Results. The mean serum NGAL concentration in the first subgroup was 192 (183; 200) ng/ml, in the second subgroup – 154 (134; 160) ng/ml. The patients with CHF of ischemic origin with tubulo-interstitial injury (according to the serum concentration of NGAL) did not differ significantly from the patients with CHF of ischemic origin without tubulo-interstitial injury in age (P = 0.950), height (P = 0.983), weight (P = 0.681), body surface area (P = 0.975). Most of left ventricular systolic function indicators showed a downward tendency (S 6.90 ± 2.85 cm/s vs. 7.67 ± 2.83 cm/s (P = 0.536); S lat 7.33 ± 2.08 cm/s vs. 11.00 ± 4.00 cm/s (P = 0.467); TEI LV 0.56 ± 0.26 c.u. vs. 0.49 ± 0.14 c.u. (P = 0.747)) in the patients with CHF of ischemic origin with elevated serum levels of NGAL compared to similar indicators in the patients with CHF of ischemic origin without tubulo-interstitial injury. The index of LVEF was significantly lower in the patients with CHF with elevated serum NGAL compared to that in the patients with CHF with normal serum NGAL (50.43 ± 17.85 % vs. 63.29 ± 13.24 % (P = 0.021)).

Conclusions. Serum NGAL was not only the sensitive marker of tubulo-interstitial injury in patients with CHF of ischemic origin, but also appeared to be a predictor of changes in systolic heart function.

Author Biographies

V. A. Lysenko, Zaporizhzhia State Medical University, Ukraine

MD, Postgraduate student of the Department of Propaedeutics of Internal Medicine, Radiation Diagnostics and Radiation Therapy

V. V. Syvolap, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Propaedeutics of Internal Medicine, Radiation Diagnostics and Radiation Therapy

M. S. Potapenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD,  Associate Professor of the Department of Anesthesiology and Intensive Care

References

Damman, K., Masson, S., Hillege, H. L., Voors, A. A., van Veldhuisen, D. J., Rossignol, P., Proietti, G., Barbuzzi, S., Nicolosi, G. L., Tavazzi, L., Maggioni, A. P., & Latini, R. (2013). Tubular Damage and Worsening Renal Function in Chronic Heart Failure. JACC: Heart Failure, 1(5), 417-424. https://doi.org/10.1016/j.jchf.2013.05.007

Ronco, C., Legrand, M., Goldstein, S. L., Hur, M., Tran, N., Howell, E. C., Cantaluppi, V., Cruz, D. N., Damman, K., Bagshaw, S. M., Di Somma, S., & Lewington, A. (2014). Neutrophil Gelatinase-Associated Lipocalin: Ready for Routine Clinical Use? An International Perspective. Blood Purification, 37(4), 271-285. https://doi.org/10.1159/000360689

Kuzmin, O. B., Zhezha, V. V., Belaynin, V. V., Buchneva, N. V., Landar, L. N., & Serdyuk, S. V. (2017). Diagnosticheskaya i prognosticheskaya tsennost' biomarkerov povrezhdeniya pochechnykh kanal'tsev NGAL, KIM-1, L-FABP u patsientov s khronicheskoi bolezn'yu pochek [Diagnostic and prognostic value of renal tubular injury biomarkers NGAL, KIM-1, L-FABP in chronic kidney disease patients]. Nefrologiya, 21(2), 24-32. [in Russian].

Bolignano, D., Coppolino, G., Lacquaniti, A., & Buemi, M. (2010). From kidney to cardiovascular diseases: NGAL as a biomarker beyond the confines of nephrology. European Journal of Clinical Investigation, 40(3), 273-276. https://doi.org/10.1111/j.1365-2362.2010.02258.x

Oikonomou, E., Tsalamandris, S., Karlis, D., Siasos, G., Chrysohoou, C., Vogiatzi, G., Dimitropoulos, S., Charalambous, G., Kouskouni, E., & Tousoulis, D. (2018). The association among biomarkers of renal and heart function in patients with heart failure: the role of NGAL. Biomarkers in Medicine, 12(12), 1323-1330. https://doi.org/10.2217/bmm-2018-0100

van Deursen, V. M., Damman, K., Voors, A. A., van der Wal, M. H., Jaarsma, T., van Veldhuisen, D. J., & Hillege, H. L. (2014). Prognostic Value of Plasma Neutrophil Gelatinase–Associated Lipocalin for Mortality in Patients With Heart Failure. Circulation: Heart Failure, 7(1), 35-42. https://doi.org/10.1161/CIRCHEARTFAILURE.113.000242

Voronkov, L. H., Amosova, K. M., Dziak, H. V., Zharinov, O. Y., Kovalenko, V. M., Korkushko, O. V., Nesukai, O. H., Sychov, O. S., Rudyk, Yu. S., & Parkhomenko, O. M. (2017). Rekomendatsii Asotsiatsii kardiolohiv Ukrainy z diahnostyky ta likuvannia khronichnoi sertsevoi nedostatnosti (2017) [Guidelines of the Ukrainian Association of Cardiology for the Diagnosis and Treatment of Chronic Heart Failure (2017)]. Sertseva nedostatnist ta komorbidni stany, (1, dodatok 1), 1-66. [in Ukranian].

WRITING COMMITTEE MEMBERS, Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Jr, Colvin, M. M., Drazner, M. H., Filippatos, G., Fonarow, G. C., Givertz, M. M., Hollenberg, S. M., Lindenfeld, J., Masoudi, F. A., McBride, P. E., Peterson, P. N., Stevenson, L. W., & Westlake, C. (2016). 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation, 134(13), e282-e293. https://doi.org/10.1161/CIR.0000000000000435

Poniatowski, B., Malyszko, J., Bachorzewska-Gajewska, H., Malyszko, J. S., & Dobrzycki, S. (2009). Serum Neutrophil Gelatinase-Associated Lipocalin as a Marker of Renal Function in Patients with Chronic Heart Failure and Coronary Artery Disease. Kidney and Blood Pressure Research, 32(2), 77-80. https://doi.org/10.1159/000208989

Maisel, A. S., Mueller, C., Fitzgerald, R., Brikhan, R., Hiestand, B. C., Iqbal, N., Clopton, P., & van Veldhuisen, D. J. (2011). Prognostic utility of plasma neutrophil gelatinase‐associated lipocalin in patients with acute heart failure: The NGAL EvaLuation Along with B‐type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial. European Journal of Heart Failure, 13(8), 846-851. https://doi.org/10.1093/eurjhf/hfr087

Damman, K., van Veldhuisen, D. J., Navis, G., Voors, A. A., & Hillege, H. L. (2008). Urinary neutrophil gelatinase associated lipocalin (NGAL), a marker of tubular damage, is increased in patients with chronic heart failure. European Journal of Heart Failure, 10(10), 997-1000. https://doi.org/10.1016/j.ejheart.2008.07.001

Alvelos, M., Pimentel, R., Pinho, E., Gomes, A., Lourenço, P., Teles, M. J., Almeida, P., Guimarães, J. T., & Bettencourt, P. (2011). Neutrophil Gelatinase-Associated Lipocalin in the Diagnosis of Type 1 Cardio-Renal Syndrome in the General Ward. Clinical Journal of the American Society of Nephrology, 6(3), 476-481. https://doi.org/10.2215/CJN.06140710

Macdonald, S., Arendts, G., Nagree, Y., & Xu, X. F. (2012). Neutrophil Gelatinase-Associated Lipocalin (NGAL) predicts renal injury in acute decompensated cardiac failure: a prospective observational study. BMC Cardiovascular Disorders, 12, Article 8. https://doi.org/10.1186/1471-2261-12-8

Mortara, A., Bonadies, M., Mazzetti, S., Fracchioni, I., Delfino, P., Chioffi, M., Bersano, C., & Specchia, G. (2013). Neutrophil gelatinase-associated lipocalin predicts worsening of renal function in acute heart failure: methodological and clinical issues. Journal of Cardiovascular Medicine, 14(9), 629-634. https://doi.org/10.2459/JCM.0b013e3283629ca6

Jungbauer, C. G., Birner, C., Jung, B., Buchner, S., Lubnow, M., von Bary, C., Endemann, D., Banas, B., Mack, M., Böger, C. A., Riegger, G., & Luchner, A. (2011). Kidney injury molecule-1 and N-acetyl-β-D-glucosaminidase in chronic heart failure: possible biomarkers of cardiorenal syndrome. European Journal of Heart Failure, 13(10), 1104-1110. https://doi.org/10.1093/eurjhf/hfr102

Shrestha, K., Shao, Z., Singh, D., Dupont, M., & Tang, W. H. (2012). Relation of Systemic and Urinary Neutrophil Gelatinase-Associated Lipocalin Levels to Different Aspects of Impaired Renal Function in Patients With Acute Decompensated Heart Failure. The American Journal of Cardiology, 110(9), 1329-1335. https://doi.org/10.1016/j.amjcard.2012.06.035

Siasos, G., Tousoulis, D., Michalea, S., Oikonomou, E., Vavuranakis, M., Athanasiou, D., Tourikis, P., Gouliopoulos, N., Miliou, A., Mourouzis, K., Limperi, M., Mazaris, S., Papavassiliou, A. G., & Stefanadis, C. (2014). Novel Biomarkers Assessing Renal Function in Heart Failure: Relation to Inflammatory Status and Cardiac Remodelling. Current Medicinal Chemistry, 21(34), 3976-3983. https://doi.org/10.2174/0929867321666140826114656

Martínez-Martínez, E., Buonafine, M., Boukhalfa, I., Ibarrola, J., Fernández-Celis, A., Kolkhof, P., Rossignol, P., Girerd, N., Mulder, P., López-Andrés, N., Ouvrard-Pascaud, A., & Jaisser, F. (2017). Aldosterone Target NGAL (Neutrophil Gelatinase-Associated Lipocalin) Is Involved in Cardiac Remodeling After Myocardial Infarction Through NFκB Pathway. Hypertension, 70(6), 1148-1156. https://doi.org/10.1161/HYPERTENSIONAHA.117.09791

Yndestad, A., Landrø, L., Ueland, T., Dahl, C. P., Flo, T. H., Vinge, L. E., Espevik, T., Frøland, S. S., Husberg, C., Christensen, G., Dickstein, K., Kjekshus, J., Øie, E., Gullestad, L., & Aukrust, P. (2009). Increased systemic and myocardial expression of neutrophil gelatinase-associated lipocalin in clinical and experimental heart failure. European Heart Journal, 30(10), 1229-1236. https://doi.org/10.1093/eurheartj/ehp088

Sahinarslan, A., Kocaman, S. A., Bas, D., Akyel, A., Ercin, U., Zengin, O., & Timurkaynak, T. (2011). Plasma neutrophil gelatinase-associated lipocalin levels in acute myocardial infarction and stable coronary artery disease. Coronary Artery Disease, 22(5), 333-338. https://doi.org/10.1097/MCA.0b013e3283472a71

Shalenkova, M. A., Mikhailova, Z. D., & Klimkin, P. F. (2018). NGAL kak marker nekotorykh vyepochechyykh oslozhnenii pri ostrom koronarnom syndrome [NGAL as a marker for some extrarenal complications in acute coronary syndrome]. Kardiologiya, 58(S3), 19-26. [in Russian].

Vlachopoulos, C., Xaplanteris, P., Aboyans, V., Brodmann, M., Cífková, R., Cosentino, F., De Carlo, M., Gallino, A., Landmesser, U., Laurent, S., Lekakis, J., Mikhailidis, D. P., Naka, K. K., Protogerou, A. D., Rizzoni, D., Schmidt-Trucksäss, A., Van Bortel, L., Weber, T., Yamashina, A., Zimlichman, R., … Townsend, R. R. (2015). The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis, 241(2), 507-532. https://doi.org/10.1016/j.atherosclerosis.2015.05.007

Downloads

Published

2021-04-16

How to Cite

1.
Lysenko VA, Syvolap VV, Potapenko MS. The relationship between systolic function and serum NGAL levels in patients with chronic heart failure of ischemic origin. Zaporozhye medical journal [Internet]. 2021Apr.16 [cited 2024Apr.20];23(2):184-8. Available from: http://zmj.zsmu.edu.ua/article/view/223741

Issue

Section

Original research