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Plasma brain injury markers are associated with volume status but not muscle health in heart failure patients

Affiliation
Cedars-Sinai Medical Center ,Departments of Neurology ,Neurosurgery and Biomedical Sciences ,Los Angeles ,CA ,United States
Lahiri, Shouri;
Affiliation
Cedars-Sinai Medical Center ,Department of Biomedical Sciences and Smidt Heart Institute ,Los Angeles ,CA ,United States
Mastali, Mitra;
Affiliation
Cedars-Sinai Medical Center ,Department of Biomedical Sciences and Smidt Heart Institute ,Los Angeles ,CA ,United States
Van Eyk, Jennifer E.;
Affiliation
Nora Eccles Harrison Cardiovascular Research and Training Institute ,University of Utah ,Salt Lake City ,UT ,United States
Hitzeman, Tara C.;
Affiliation
Biostatistics and Informatics Core ,Cancer Institute ,Cedars-Sinai Medical Center ,Los Angeles ,CA ,United States
Bresee, Catherine;
Affiliation
Cedars-Sinai Medical Center ,Department of Biomedical Sciences and Smidt Heart Institute ,Los Angeles ,CA ,United States
Raedschelders, Koen;
Affiliation
Zilkha Neurogenetic Institute of the Keck School of Medicine ,University of South California ,Los Angeles ,CA ,United States
Lyden, Patrick D.;
Affiliation
Cedars-Sinai Medical Center ,Department of Biomedical Sciences and Smidt Heart Institute ,Los Angeles ,CA ,United States
Gottlieb, Roberta A.;
Affiliation
Department of Medicine ,Division of Cardiovascular Medicine ,University of Utah ,Salt Lake City ,UT ,United States
Fang, James C.;
Affiliation
Nora Eccles Harrison Cardiovascular Research and Training Institute ,University of Utah ,Salt Lake City ,UT ,United States
Shaw, Robin M.;
Affiliation
Nora Eccles Harrison Cardiovascular Research and Training Institute ,University of Utah ,Salt Lake City ,UT ,United States
Hong, Ting Ting

Background: Neurofilament light chain protein (NfL) and tau are plasma biomarkers of neuronal injury which can be elevated in patients with neurodegenerative diseases. N-terminal pro-brain natriuretic peptide (NT-proBNP) is an established marker of volume status in patients with heart failure (HF) and plasma cBIN1 score (CS) is an emerging biomarker of cardiac muscle health. It is not known if, in HF patients, there is a correlation between cardiac markers and brain injury markers. Methods: We studied ambulatory HF patients with either preserved and reduced ejection fraction (N = 50 with 25 HFrEF and 25 HFpEF) and age and sex matched healthy controls (N = 50). Plasma NT-proBNP and CS were determined using commercial kits. A bead-based ELISA assay was used to quantify femtomolar concentrations of plasma neuronal markers NfL and total tau. Results: Plasma levels of NT-proBNP and CS in heart failure patients were significantly higher than those from healthy controls. In both patients with HFrEF and HFpEF, we found independent and direct correlations between the volume status marker NT-proBNP, but not the cardiomyocyte origin muscle health marker CS, with NfL ( r = 0.461, p = 0.0007) and tau ( r = 0.333, p = 0.0183). Conclusion: In patients with HF with or without preserved ejection fraction, plasma levels of NfL and tau correlate with volume status rather than muscle health, indicating volume overload-associated neuronal injury.

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License Holder: Copyright © 2022 Lahiri, Mastali, Van Eyk, Hitzeman, Bresee, Raedschelders, Lyden, Gottlieb, Fang, Shaw and Hong.

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