Circulating activin A is a surrogate for the incidence of diastolic dysfunction and heart failure in patients with preserved ejection fraction

Yi Lin Tsai, Ruey Hsing Chou, Chin Sung Kuo, Chun Chin Chang, Cheng Hsueh Wu, Po Hsun Huang, Jaw Wen Chen, Shing Jong Lin

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Diastolic dysfunction (DD) is a characteristic of heart failure with preserved ejection fraction (HFpEF), which is thought to be caused by cardiac hypertrophy or fibrosis. Activin A is involved in the inflammatory response and myocardial fibrosis, but the relationship between the activin A level and DD remains unclear. Methods and Results: A total of 209 patients with stable angina were enrolled. Serum activin A levels were assessed, and echocardiography and cross-sectional analysis were performed. Among the subjects (65% male; mean age, 70±13 years), 84 (40%) subjects had DD. The subjects were divided into tertiles based on activin A levels. Patients in the high activin A group had enhanced left ventricular mass indexes, medial E/e’ ratios, left atrial diameter, and right ventricular systolic pressure compared with those in the lower activin A groups (all P<0.001). Prevalence of DD (P=0.001), HFpEF at enrollment (P=0.007), and the composite endpoints including new-onset heart failure (HF) or death within 3 years (P<0.001) correlated positively with high activin A levels. After adjusting for confounding factors, high activin A levels remained significantly associated with DD (P=0.036) and the composite endpoints (P=0.012). Conclusions: Enhanced serum activin A levels were associated with the incidence of DD and development of HF.

Original languageEnglish
Pages (from-to)1514-1519
Number of pages6
JournalCirculation Journal
Volume83
Issue number7
DOIs
Publication statusPublished - 2019
Externally publishedYes

Keywords

  • Activin A
  • Diastolic dysfunction
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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