Serum Osteopontin as a Predictor of Severity in Patients with Heart Failure: Correlation with Clinical and Echocardiographic Parameters
Background and objectives: Many biomarkers were recently investigated as possible diagnostic and prognostic makers in heart failure (HF). The authors hypothesized that estimation of serum osteopontin (OPN) level can be a predictor of severity in patients with left sided and right sided heart failure and may be related to clinical and echocardiographic parameters. Methods: Forty patients with left sided HF (group I) (mean age 63.7 ± 6.88), 40 patients with right sided HF (group II) (mean age 59.22 ± 12.12) and 20 healthy individuals (group III) (mean age 57.35 ± 6.40) were included. Measurement of serum brain natriuretic peptide (BNP) and OPN was done. All subjects underwent echocardiography using two-dimensional strain imaging. Left ventricular (LV) and right ventricular (RV) peak longitudinal systolic strain (εsys) were measured in apical views. The BNP and OPN levels were correlated with the conventional echocardiographic parameters and LV and RV longitudinal εsys. Results: In patients with left sided HF (group I), serum BNP and OPN levels were significantly higher than in group II (patients with right sided HF), and both groups showed significant higher values than in group III (controls) (P<0.01). In group I, levels of both BNP and OPN showed significant inverse correlation with ejection fraction (EF) and LV longitudinal εsys (P<0.001 and P<0.01 respectively), while they showed significant positive correlation with NYHA class (P<0.014 and P<0.002 respectively). In group II, BNP levels showed significant positive correlation with pulmonary artery systolic pressure (PASP) (P<0.04). Furthermore, OPN levels showed significant positive correlation with BNP levels in group I (P<0.001). Conclusion: Patients with heart failure have high serum level of OPN that is correlated with myocardial longitudinal strain. In patients with left sided heart failure, OPN has significant correlations with EF, NYHA class and BNP level and can be used as a predictor of severity in such patients.