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Association of plasma cardiotrophin-1 with stage C heart failure in hypertensive patients: Potential diagnostic implications

López, Begoñaa; González, Arantxaa; Querejeta, Ramónb; Barba, Joaquínc; Díez, Javiera,c

doi: 10.1097/HJH.0b013e32831ac981
Original papers: Heart

Cardiotrophin-1 is a cytokine that induces hypertrophy and dysfunction in cardiomyocytes and has been shown to be increased in hypertensive patients. The objective of this study was to evaluate the association of cardiotrophin-1 with heart failure (HF) in hypertensive patients and its usefulness as a biomarker of stage C heart failure. Hypertensive patients without cardiac abnormalities (stage A, n = 64), with left ventricular hypertrophy (LVH) (stage B, n = 58), and with left ventricular hypertrophy and clinical manifestations of chronic heart failure (stage C, n = 39) were studied. Plasma cardiotrophin-1 was measured by an enzyme-linked inmunosorbent assay. Plasma cardiotrophin-1 progressively increased (P < 0.001), along with progression of heart failure stages, in hypertensive patients. Plasma cardiotrophin-1 was directly (r = 0.416, P < 0.001) and inversely (r = 0.263, P < 0.01) correlated with left ventricular (LV) mass index and ejection fraction, respectively, in all hypertensive patients. These associations were independent of a number of potential confounding factors. Receiver operating characteristic curves showed that a cut-off of 48.72 fmol/ml for cardiotrophin-1 provided higher sensitivity for diagnosing stage C heart failure than a cut-off of 375.54 pg/ml for amino-terminal probrain natriuretic peptide (NT-proBNP) (80% vs. 72%). Sixty-four percent of stage C hypertensive patients with NT-proBNP values below 375.54 pg/ml value exhibited cardiotrophin-1 values above 49.16 fmol/ml. These findings indicate that plasma cardiotrophin-1 is associated with progression of heart failure in hypertensive patients. Cardiotrophin-1 measurement may provide additional information to that afforded by NT-proBNP to diagnose stage C heart failure in these patients.

aDivision of Cardiovascular Sciences, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain

bDivision of Cardiology, Donostia University Hospital, San Sebastián, Spain

cDepartment of Cardiology and Cardiovascular Surgery, University Clinic, University of Navarra, Pamplona, Spain

Received 27 May, 2008

Revised 16 September, 2008

Accepted 23 September, 2008

Correspondence to Javier Díez, MD, PhD Área de Ciencias Cardiovasculares, Edificio CIMA, Av. Pio XII, 55. 31008 Pamplona, Spain Tel: +34 948 194700; fax: +34 948 194716; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.