Polybiomarker approach in myocardial dysfunction assessment in senile patients

Purpose: to evaluate interaction of obesity, inflammation and myocardial dysfunction in senile myocardial infarction survivors. Material and Methods. Patients aged 70 and older were involved in the study (n=108) and divided into 2 groups according to the history of myocardial infarction (Ml) — 5 years before involvement: senile Ml survivors (n=26) vs senile patients without history of Ml (n=82). Measurements of serum levels of adipokines (leptin, adiponectin), myocardial dysfunction markers (BNP, NT proBNP, proANP, galectin 3) and inflammatory cytokines (TNF, interleukin 6) were performed. Results. Both groups were comparable by age and major clinical characteristics. Ejection fraction was preserved in both groups under the study (67 (64; 70) %vs67 (64; 68) %, p=0,655). Frequency of diastolic dysfunction was comparable in both groups. However it was more severe in Ml survivors. BNP and NT proBNP levels were significantly lower in patients without the history of Ml (p=0,021; 0,004, respectively). On the contrary serum levels of proANP had tendency to increase in patients with the history of Ml, but not significantly: p=0,821. Adiponectin and galectin-3 were significantly higher in patients with the history of Ml (p=0,019and p=0,011). Conclusion. Pathogenetic peculiarities of chronic heart failure with preserved ejection fraction in senile patients with and without myocardial infarction history were revealed. More expedient biomarker panel appropriate for senile patients with probable heart failure should include NT-proBNP, galectin-3 and adiponectin.