RT Journal Article
SR Electronic
T1 Hepatocyte growth factor is a strong predictor of mortality in patients with advanced heart failure
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1158
OP 1163
DO 10.1136/hrt.2010.220228
VO 97
IS 14
A1 Kathrin Rychli
A1 Bernhard Richter
A1 Philipp J Hohensinner
A1 Kariem Mahdy Ali
A1 Stephanie Neuhold
A1 Gerlinde Zorn
A1 Rudolf Berger
A1 Deddo Mörtl
A1 Kurt Huber
A1 Richard Pacher
A1 Johann Wojta
A1 Alexander Niessner
A1 Martin Hülsmann
YR 2011
UL http://heart.bmj.com/content/97/14/1158.abstract
AB Objective To assess the prognostic value of the mitogenic, antiapoptotic, angiogenic and antifibrotic hepatocyte growth factor (HGF) in heart failure (HF).Design Prospective cohort study.Setting/patients Assessment of HGF levels at inclusion in 351 patients with advanced HF (median 75 years, interquartile range (IQR) 63–82, 66% male).Main outcome measures All-cause mortality, cardiovascular mortality.Results During a median follow-up of 16 months, 26% of patients died. HGF tertiles were associated with an increasing risk for all-cause mortality (p<0.001) with a hazard ratio (HR) of 3.06 (95% confidence interval (CI) 1.69 to 5.53) for the third compared with the first tertile. This association remained significant after multivariable adjustment for B-type natriuretic peptide (BNP) and other risk factors (p=0.002). Subgroup analysis revealed that HGF was a strong predictor of the secondary end point cardiovascular mortality in ischaemic HF (p=0.009) with an adjusted HR of 6.2 (95% CI 1.76 to 21.8) comparing the third with the first tertile but not in non-ischaemic HF (HR=1.47, 95% CI 0.48 to 4.49, p=0.5). Patients with high HGF but low BNP had a comparable survival rate to those with elevated BNP but low HGF (p=0.66). Of note, the dose of angiotensin converting enzyme (ACE) inhibitors inversely correlated with HGF concentrations (r=−0.25, p<0.001).Conclusions HGF is a strong and independent predictor of mortality in advanced HF and, in particular, in ischaemic HF. These results indicate that HGF with its multiple effects on myocardial function exerts an overall deleterious effect in advanced HF. HGF may be of special interest for risk prediction and tailoring of HF treatment.