Universität zu Köln

Ferreira, Joao Pedro ORCID: 0000-0002-2304-6138, Duarte, Kevin, Woehrle, Holger, Cowie, Martin R., Wegscheider, Karl, Angermann, Christiane, d'Ortho, Marie-Pia, Erdmann, Erland, Levy, Patrick, Simonds, Anita K., Somers, Virend K., Teschler, Helmut, Rossignol, Patrick, Koenig, Wolfgang and Zannad, Faiez (2020). Biomarkers in patients with heart failure and central sleep apnoea: findings from the SERVE-HF trial. ESC Heart Fail., 7 (2). S. 503 - 512. SAN FRANCISCO: WILEY PERIODICALS, INC. ISSN 2055-5822

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Abstract

Aims The Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnoea by Adaptive Servo Ventilation in Patients with Heart Failure trial investigated the effects of adaptive servo-ventilation (ASV) (vs. control) on outcomes of 1325 patients with heart failure and reduced ejection fraction (HFrEF) and central sleep apnoea (CSA). The primary outcome (a composite of all-cause death or unplanned HF hospitalization) did not differ between the two groups. However, all-cause and cardiovascular (CV) mortality were higher in the ASV group. Circulating biomarkers may help in better ascertain patients' risk, and this is the first study applying a large set of circulating biomarkers in patients with both HFrEF and CSA. Methods and results Circulating protein-biomarkers (n = 276) ontologically involved in CV pathways, were studied in 749 (57% of the trial population) patients (biomarker substudy), to investigate their association with the study outcomes (primary outcome, CV death and all-cause death). The mean age was 69 +/- 10 years, and > 90% were male. The groups (ASV vs. control and biomarker substudy vs. no biomarker) were well balanced. The best clinical prognostic model included male sex, systolic blood pressure < 120 mmHg, diabetes, loop diuretic, cardiac device, 6-min walking test distance, and N-terminal pro BNP as the strongest prognosticators. On top of the best clinical prognostic model, the biomarkers that significantly improved both the discrimination (c-index) and the net reclassification index (NRI) of the model were soluble suppression of tumorigenicity 2 for the primary outcome; neurogenic locus notch homolog protein 3 (Notch-3) for CV-death and all-cause death; and growth differentiation factor 15 (GDF-15) for all-cause death only. Conclusions We studied 276 circulating biomarkers in patients with HFrEF and central sleep apnoea; of these biomarkers, three added significant prognostic information on top of the best clinical model: soluble suppression of tumorigenicity 2 (primary outcome), Notch-3 (CV and all-cause death), and GDF-15 (all-cause death).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ferreira, Joao Pedro UNSPECIFIED orcid.org/0000-0002-2304-6138 UNSPECIFIED Duarte, Kevin UNSPECIFIED UNSPECIFIED UNSPECIFIED Woehrle, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Cowie, Martin R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegscheider, Karl UNSPECIFIED UNSPECIFIED UNSPECIFIED Angermann, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED d'Ortho, Marie-Pia UNSPECIFIED UNSPECIFIED UNSPECIFIED Erdmann, Erland UNSPECIFIED UNSPECIFIED UNSPECIFIED Levy, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Simonds, Anita K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Somers, Virend K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Teschler, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Rossignol, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Koenig, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Zannad, Faiez UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-348653
DOI:	10.1002/ehf2.12521
Journal or Publication Title:	ESC Heart Fail.
Volume:	7
Number:	2
Page Range:	S. 503 - 512
Date:	2020
Publisher:	WILEY PERIODICALS, INC
Place of Publication:	SAN FRANCISCO
ISSN:	2055-5822
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GROWTH-DIFFERENTIATION FACTOR-15; REDUCED EJECTION FRACTION; RISK STRATIFICATION; PROGNOSTIC VALUE; SOLUBLE ST2; MORTALITY; VENTILATION; MECHANISMS; DIAGNOSIS; PRESSURE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34865